Individual provider Active NPI

Crawford Haralson Cleveland, M.D.

  • Allergy Physician
  • Pensacola, FL
National Provider Identifier
1114926474
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
ME40493 Issued in FL
Practice address
3298 Summit Blvd
Suite 40
Pensacola, FL 32503-8318
Phone
(850) 469-8010
Fax
(850) 469-0980
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X ME40493 FL Primary

Addresses

Primary practice location

3298 Summit Blvd
Suite 40
Pensacola, FL 32503-8318

Mailing address

3298 Summit Blvd
Suite 40
Pensacola, FL 32503-8318
Phone (850) 469-8010

Other identifiers 1

IdentifierTypeStateIssuer
066944000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000641 FL Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 3577731496 Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Cleveland, MD Allergy PastSince Aug 16, 1982 Accepting new patients
NPI 1508468638 Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1114926474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3298 SUMMIT BLVD",
            "address_2": "SUITE 40",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325038318",
            "telephone_number": "850-469-8010",
            "fax_number": "850-469-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3298 SUMMIT BLVD",
            "address_2": "SUITE 40",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325038318",
            "telephone_number": "850-469-8010",
            "fax_number": "850-469-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "CRAWFORD",
        "middle_name": "HARALSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "FL",
            "license": "ME40493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066944000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.