Active NPI
Tracy L. Cleveland, PA-C
- Physician Assistant
- Springfield, MO
National Provider Identifier
1205975935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2003010854
- Practice address
- 1229 E Seminole St
Springfield, MO 65804-2227 - Phone
- (417) 820-5610
- Fax
- (417) 829-5588
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2003010854 | MO | Primary |
Addresses
Primary practice location
1229 E Seminole St
Springfield, MO 65804-2227
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- tcleveland718@directb.mercy.net
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1205975935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 E SEMINOLE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042227",
"telephone_number": "417-820-5610",
"fax_number": "417-829-5588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVELAND",
"first_name": "TRACY",
"middle_name": "L.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2003010854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.