Adeline Cleveland

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT9402 Issued in NM

Practice address

618 Paseo de Peralta Ste a
Santa Fe, NM 87501-1984

Phone

(505) 989-1818

NPI assigned

Oct 12, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1760144125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493",
            "city": "TESUQUE",
            "state": "NM",
            "postal_code": "875740493",
            "telephone_number": "802-989-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 PASEO DE PERALTA STE A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011984",
            "telephone_number": "505-989-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "ADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "MT9402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT LICENSE",
            "identifier": "MT9402",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mandalamedicine.com",
            "affiliation": "N",
            "address_1": "618 Paseo De Peralta Ste A",
            "city": "Santa Fe",
            "state": "NM",
            "country_code": "US",
            "postal_code": "875011984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarha Lillian Clark, LMSW
• Corey D Clay, MD, PHD
• Michael Barnett Clayman, DDS
• Benjamin Thomas Clayton del Toro, PHARM.D., PH.D.
• Clear Vision Inc.
• Kelly Marie Clifford
• Angela Rae Cline, PA
• Matthew Jared Clokey Jr., BMS
• Brent Lane Clovis, LMSW
• Coastline Medicals LLC

• Massage Therapist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Massage Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.