Benicia Elaine Cleveland, MED, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1231 Issued in NC

Practice address

1250 S Martin Luther King Jr. Drive
Winston-Salem State University
Winston-Salem, NC 27107

Phone

(336) 750-2597

Fax

(336) 750-8880

NPI assigned

Apr 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Winston Salem State University, a. H. Ray Student Health Service

  • Student Health Clinic/Center
  • Winston Salem, NC
  • NPI 1376716811
  NPD (past)
• Winston-Salem State University

  dba WSSU Sports Medicine

  • Student Health Clinic/Center
  • Winston Salem, NC
  • NPI 1144649948
  NPD (past)

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1629212501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S MARTIN LUTHER KING JR. DRIVE",
            "address_2": "WINSTON-SALEM STATE UNIVERSITY",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27107",
            "telephone_number": "336-750-2597",
            "fax_number": "336-750-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S MARTIN LUTHER KING JR. DRIVE",
            "address_2": "WINSTON-SALEM STATE UNIVERSITY",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27107",
            "telephone_number": "336-750-2597",
            "fax_number": "336-750-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "BENICIA",
        "middle_name": "ELAINE",
        "credential": "MED, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "1231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie Clement, CRNA
• Dalice D Clement
• Grace Taiyu Evadare Clements
• Clerico Optometry, P.a.
• John Clerico, O.D.
• Barbara Ann Clifford, MD
• Lucy M Clifford, MS, CCC-SLP
• Bonnie M. Clifton, RPSGT REEGT
• Meredith Gordon Clifton, PA-C
• Climbing Jacobs Ladder Inc

• Athletic Trainer in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.