Cleveland Family Health Clinic, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2011-00283 Issued in NC

Legal business name

CLEVELAND FAMILY HEALTH CLINIC, PLLC

Practice address

22 Shipwash Drive
Garner, NC 27529

Phone

(919) 662-7600

Fax

(919) 662-7675

NPI assigned

Aug 11, 2015

Organization subpart

No

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

Authorized official

Name

Marian J. Bullard, P.A. C

Title

Owner

Phone

(919) 662-7600

Specialties & licenses 2

Addresses

Other names 1

• Marian J. Bullard PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13506/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Jamie Hisae Bledsoe, FNP

  • Family Nurse Practitioner
  • Garner, NC
  • NPI 1558986398
  Medicare reassignment Care Compare group NPD
• Marian Jeanette Keen, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Garner, NC
  • NPI 1538304837
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1235515446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SHIPWASH DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275296861",
            "telephone_number": "919-662-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SHIPWASH DRIVE",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "27529",
            "telephone_number": "919-662-7600",
            "fax_number": "919-662-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND FAMILY HEALTH CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-662-7600",
        "authorized_official_credential": "P.A. C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-00283",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marian J. Bullard PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sharodera Clark
• Vaughn Kimberly Clark, MSN, APRN, FNP-C
• Marsha Alicia Clarke, LCSW
• Cathy Ann Clement, LPC
• Cleveland Chiropractic and Massage PLLC
• Cleveland Family Health, PA
• Clinical Staffing Inc. Dba Dzeel Clinical
• Clinical Vybez Counseling & Consulting, PLLC
• Sarah R Coates, LCMHC
• Lauren Cobb

• Family Medicine Physician in Garner, NC
• Providers in Garner, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.