Lee A Cleveland, RD CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1864 Issued in WI

Practice address

1550 Midway PL
Menasha, WI 54952-1165

Phone

(920) 585-4961

Fax

(920) 727-8001

NPI assigned

Sep 28, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 23, 2013.

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1295722957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5008 GOLF COURSE RD",
            "address_2": "#604",
            "city": "SHERWOOD",
            "state": "WI",
            "postal_code": "541699723",
            "telephone_number": "920-585-4961",
            "fax_number": "920-727-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521165",
            "telephone_number": "920-585-4961",
            "fax_number": "920-727-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "LEE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "RD  CDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carri Ann Ciske, LPC-IT
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• Kahli J Compton, LCSW, APSW

• All providers in Menasha, WI
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.