Ivy Cleveland, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN174879 Issued in GA

Practice address

2429 Main St E
Snellville, GA 30078-3336

Phone

(404) 576-8680

NPI assigned

Jan 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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.

• Anu Glo Med Spa, LLC.

  • Adult Health Nurse Practitioner
  • Snellville, GA
  • NPI 1508470212

  Acute Care

  NPD Authorized official

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1801034731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 STONEGATE WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786701",
            "telephone_number": "404-664-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 MAIN ST E",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783336",
            "telephone_number": "404-576-8680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 clairmont road",
            "address_2": "va medical center",
            "address_purpose": "LOCATION",
            "city": "decatur",
            "state": "GA",
            "postal_code": "30033",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "IVY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN555465",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN174879",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "174879",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "174879",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN174879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Clark, RBT
• Will Clark, MS, APC, NCC
• Sonji Clarke-Allen
• Damaris Claudio, LCSW
• David Cleope, CADC II, CCDS, MRT
• Carlotta Cloud, LPC
• Charity Coer-Sims, RBT
• Eric Coile, RBT
• Deborah Lee Coker, DMD
• Jessica Lashae Coker, DNP

• Adult Health Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.