NPIMap

Organization Active NPI

Cleveland VA Cboc

  • Clinic/Center
  • Cleveland, WI
National Provider Identifier
1154337558
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
8882-031 Issued in WI
Legal business name
CLEVELAND VA CBOC
Practice address
1205 North Ave
Cleveland, WI 53015-1413
Phone
(188) 469-6614
NPI assigned
Jul 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Agnes E. DeehrNPI 1881614683
Title
LPN
Phone
(920) 693-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 8882-031 WI Primary

Addresses

Primary practice location

1205 North Ave
Cleveland, WI 53015-1413

Mailing address

336 E Jefferson Ave
Cleveland, WI 53015-1530
Phone (920) 693-8478

National Provider Directory

National Provider Directory

Locations

1205 North Ave
Cleveland, WI 53015
Phone (920) 693-5600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154337558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 E JEFFERSON AVE",
            "city": "CLEVELAND",
            "state": "WI",
            "postal_code": "530151530",
            "telephone_number": "920-693-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 NORTH AVE",
            "city": "CLEVELAND",
            "state": "WI",
            "postal_code": "530151413",
            "telephone_number": "188-469-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND VA CBOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEEHR",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "920-693-5600"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "8882-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.