Craig Webster Cleveland, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

532 Issued in MS

Practice address

202 N 2ND St
Booneville, MS 38829-2702

Phone

(662) 728-6191

Fax

(662) 728-9430

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

• Craig W. Cleveland, O.D., P.a.

  • Optometrist
  • Booneville, MS
  • NPI 1487784518
  Authorized official Same address or phone

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1396859054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N 2ND ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292702",
            "telephone_number": "662-728-6191",
            "fax_number": "662-728-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N 2ND ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292702",
            "telephone_number": "662-728-6191",
            "fax_number": "662-728-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "CRAIG",
        "middle_name": "WEBSTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880096",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06985007",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Chisholm, CMHT
• CHR of Booneville, Inc. (Caring Hands Rehab)
• Desiree Patience Nicole Chupp
• Kelly Clark
• CLC of Booneville, LLC (Longwood Community Living Center)
• Amy Cole, R.N.
• Melody Anne Cole, APRN
• Ronja Cole, N.P.
• Felton Combest, MD
• Amy Downs Coogler, D.M.D.

• Optometrist in Booneville, MS
• Providers in Booneville, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.