Cleveland Children's Clinic, PLLC
NPI 1093178337ActiveOrganization· Pediatrics· Cleveland, MS
Pediatrics in Cleveland, Mississippi, registered in NPPES in April 2016. The authorized official on file is Jose Brevil, ED.D., Executive Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1093178337 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 4, 2016 |
| Last updated in NPPES | Jul 20, 2023 |
| Certified by provider | Jul 20, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
| Pediatrics | 208000000X | 23162 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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