Individual provider Active NPI

Regina Cleveland, LPN

  • Licensed Practical Nurse
  • Carnesville, GA
National Provider Identifier
1861587271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
051105 Issued in GA
Practice address
6955 Hwy 145 South
Carnesville, GA 30521
Phone
(706) 384-5575
Fax
(706) 384-4217
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 051105 GA Primary

Addresses

Primary practice location

6955 Hwy 145 South
Carnesville, GA 30521

Mailing address

95 Gray Road
Carnesville, GA 30521
Phone (706) 384-5280

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051105GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin County Board of Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861587271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 GRAY ROAD",
            "city": "CARNESVILLE",
            "state": "GA",
            "postal_code": "30521",
            "telephone_number": "706-384-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6955 HWY 145 SOUTH",
            "city": "CARNESVILLE",
            "state": "GA",
            "postal_code": "30521",
            "telephone_number": "706-384-5575",
            "fax_number": "706-384-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "REGINA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "051105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carnesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.