CLEVELAND CHILDREN'S CLINIC, PLLC
NPI 1093178337
Pediatrics in Cleveland, MS
About Cleveland Children's Clinic, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLEVELAND CHILDREN'S CLINIC, PLLC (NPI 1093178337) is a healthcare organization registered as a pediatrics in Cleveland, Mississippi and active in the NPI registry since April 2016. The organization holds 2 active CLIA laboratory certificates and lists Jose Brevil, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cleveland Children's Clinic, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Cleveland Children's Clinic, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 25D2111970
Cleveland Children's Clinic, PLLC · Cleveland, MSCertificate of Waiver 25D2291313
Cleveland Children's Clinic - Greenville · Greenville, MSFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Cleveland Children's Clinic, PLLC's NPI number?
The NPI number for Cleveland Children's Clinic, PLLC is 1093178337. It was assigned to this organization in the NPPES registry on April 4, 2016.
Where is Cleveland Children's Clinic, PLLC located?
Cleveland Children's Clinic, PLLC is located at 818 E Sunflower Rd, Cleveland, MS 38732. The listed phone number is (662) 579-3449.
What is Cleveland Children's Clinic, PLLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Cleveland Children's Clinic, PLLC enrolled in Medicare?
Yes. Cleveland Children's Clinic, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Cleveland Children's Clinic, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Cleveland Children's Clinic, PLLC, in Nurse Practitioner and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Cleveland Children's Clinic, PLLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Cleveland Children's Clinic, PLLC was last updated on July 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Cleveland Children's Clinic, Pllc · NPI 1093178337
Pediatrics organization in Cleveland, Mississippi. Organization record, active in the CMS NPPES registry since April 4, 2016.
## Identity
- **NPI:** 1093178337 (Entity type: Organization)
- **Enumerated:** April 4, 2016
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Jose Brevil, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 818 E SUNFLOWER RD, Cleveland, MS 38732-2824
- **Phone:** (662) 579-3449 · **Fax:** (662) 579-3459
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (1), Pediatric Medicine (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 20, 2023
- **Other identifiers:** Medicaid 00325056 (MS)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093178337) · Data from the CMS NPPES public registry.