Individual provider Active NPI

Cynthia Cleveland, M.D.

  • Specialist
  • Rochester, MN
National Provider Identifier
1912908112
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
31755 Issued in MN
Practice address
300 1St Ave NW
Suite 230
Rochester, MN 55901-2830
Phone
(507) 361-1231
Fax
(507) 361-1241
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 31755 MN Primary

Addresses

Primary practice location

300 1St Ave NW
Suite 230
Rochester, MN 55901-2830

Mailing address

300 1St Ave NW
Suite 230
Rochester, MN 55901-2830
Phone (507) 361-1231

Other identifiers 1

IdentifierTypeStateIssuer
317207400MedicaidMN

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

LicenseStateTypeSpecialty
31755MNMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1912908112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 1ST AVE NW",
            "address_2": "SUITE 230",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012830",
            "telephone_number": "507-361-1231",
            "fax_number": "507-361-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST AVE NW",
            "address_2": "SUITE 230",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012830",
            "telephone_number": "507-361-1231",
            "fax_number": "507-361-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "31755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317207400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.