Active NPI
Leland Cleveland, M.D.
- Family Medicine Physician
- Jonesborough, TN
National Provider Identifier
1780689828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35859
- Practice address
- 415 Boones Creek Rd
Jonesborough, TN 37659-5165 - Phone
- (423) 788-3080
- Fax
- (423) 913-2810
- NPI assigned
- Jun 16, 2005
- Last updated
- May 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35859 | TN | Primary |
Addresses
Primary practice location
415 Boones Creek Rd
Jonesborough, TN 37659-5165
Mailing address
415 Boones Creek Rd
Jonesborough, TN 37659-5165
Phone (423) 788-3080
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1517795 | Medicaid | TN | |
| 1517920 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35859 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Empire Radiology Inc PC | Past | Accepting new patients | |
| Emergency Care Physicians, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/2378/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Johnson City, TN
- NPI 1669410304
-
- Diagnostic Radiology Physician
- Johnson City, TN
- NPI 1093762759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1780689828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 BOONES CREEK RD",
"city": "JONESBOROUGH",
"state": "TN",
"postal_code": "376595165",
"telephone_number": "423-788-3080",
"fax_number": "423-913-2810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BOONES CREEK RD",
"city": "JONESBOROUGH",
"state": "TN",
"postal_code": "376595165",
"telephone_number": "423-788-3080",
"fax_number": "423-913-2810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVELAND",
"first_name": "LELAND",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "35859",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1517795",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1517920",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesborough, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.