Craig W. Cleveland, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

532 Issued in MS

Legal business name

CRAIG W. CLEVELAND, O.D., P.A.

Practice address

202 N 2ND St
Booneville, MS 38829-2702

Phone

(662) 728-6191

Fax

(662) 728-9430

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Craig W Cleveland, O.D.

Title

President

Phone

(662) 728-6191

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Optometry Other name

Locations

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1487784518",
    "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": {
        "organization_name": "CRAIG W. CLEVELAND, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-728-6191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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": [
        {
            "organization_name": "Family Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Brittany Lane Cox, LCSW
• Davidson Pharmacy, LLC
• Laurence L Dennis, MD
• Mallie Marie Dennis, MD
• Judy Dillard, CPSS
• Angela Shantel Dockery

• 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 Dec 27, 2012; 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.