Cleveland Clinic Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLEVELAND CLINIC CORP

Practice address

300 E Crockett St
Cleveland, TX 77327-4029

Phone

(281) 592-3344

Fax

(281) 593-0952

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Charles Fulner

Title

Officer/Director

Phone

(502) 777-8128

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1790055754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E CROCKETT ST",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E CROCKETT ST",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274029",
            "telephone_number": "281-592-3344",
            "fax_number": "281-593-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "FULNER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OFFICER/DIRECTOR",
        "authorized_official_telephone_number": "502-777-8128"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sreenivasulu Cherlo, M.D.
• Erica Chisem
• Shaneika Nicole Citizen, CNA
• City of Cleveland
• Carla Andrea Claros, APRN
• Cleveland Dental PLLC
• Cleveland Diagnostic Center PA
• Cleveland Emergency Group PA
• Cleveland General Hospital LLC
• Cleveland Imaging and Surgical Hospital, L.L.C.

• All providers in Cleveland, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.