Benjamin Cleveland, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

911 Issued in OK

Practice address

500 W University St
Shawnee, OK 74804-2522

Phone

(405) 585-5351

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oklahoma Baptist University

  • Student Health Clinic/Center
  • Shawnee, OK
  • NPI 1083913131
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1578971636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43777 HUNTERS HILL DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748018938",
            "telephone_number": "251-623-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W UNIVERSITY ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042522",
            "telephone_number": "405-585-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "BENJAMIN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "1261",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OK",
            "license": "911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanner Clark, M.S.
• Stacey Clary, BHA
• Norma Cleere, LPN
• Lacy Clemmons
• Robert Clendenin, MD
• Carol Bearly Cleveland
• Jeffrey Cleveland
• Russell Craig Click, M.D.
• Nicklaus Clifford, D.D.S.
• CMN Enterprises,LLC (Action Limb and Brace)

• Athletic Trainer in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Athletic Trainer in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.