BOLIVAR MEDICAL CENTER LONG TERM CARE FACILITY
NPI 1316984453
Skilled Nursing Facility in Cleveland, MS

Active since May 31, 2006CLIA Certified · 2 labs
901 E SUNFLOWER RD, CLEVELAND, MS 38732(662) 846-0061(662) 846-2380 Get Directions Write a Review

NPPES record last updated: March 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 9, 2019, Jun 13, 2017 (2 updates tracked since 2017).

About Bolivar Medical Center Long Term Care Facility NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOLIVAR MEDICAL CENTER LONG TERM CARE FACILITY (NPI 1316984453) is a healthcare organization registered as a skilled nursing facility in Cleveland, Mississippi and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Kathy Teague, Vice President, Corporate Secretary, as its authorized official.

NPPES Registry Identity

NPI1316984453
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePHC-CLEVELAND INC.
Location Address901 E SUNFLOWER RDCleveland, MS 38732-2833
Mailing Address330 Seven Springs WayBrentwood, TN 37027-4536 · (615) 920-7000 · Fax (615) 920-8913
Fax(662) 846-2380
Organization SubpartNo
Authorized OfficialKathy TeagueVice President, Corporate Secretary · (629) 253-5121
Enumeration DateMay 31, 2006
Last NPPES UpdateMarch 11, 20242 updates tracked since enumeration
NPPES CertifiedMarch 11, 2024
NPI 1316984453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MS · 151
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
901 E SUNFLOWER RD, Cleveland, MS 38732

Other Names 1

Doing Business AsBolivar Medical Center Long Term Care Facility

Other Identifiers 2

Other000080746MS · Blue Cross/snf
Medicaid0230097MS

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 Accreditation 25D0651780

Phc Cleveland Inc Dba Bolivar Medical Center · Cleveland, MS
Active · expires Jan 2, 2027
CLIA Number25D0651780
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorRyan Campbell
Laboratory Phone(662) 846-2512
Laboratory LocationPhc Cleveland Inc Dba Bolivar Medical Center901 East Sunflower Road, Cleveland, MS 38732
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 25D2193416

Bolivar Medical Center Long Term Care · Cleveland, MS
Active · expires Sep 20, 2026
CLIA Number25D2193416
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 21, 2024
Certificate Expiration DateSeptember 20, 2026
Laboratory DirectorJessica Robinson
Laboratory Phone(662) 846-2459
Laboratory LocationBolivar Medical Center Long Term Care901 E Sunflower Rd, Cleveland, MS 38732
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
901 E SUNFLOWER RD
CLEVELAND, MS 38732
Radiology (Vascular & Interventional Radiology)
901 E SUNFLOWER RD
CLEVELAND, MS 38732
Emergency Medicine
901 E SUNFLOWER RD
CLEVELAND, MS 38732
Nurse Anesthetist, Certified Registered
901 E SUNFLOWER RD, BOLIVAR COUNTY HOSPITAL
CLEVELAND, MS 38732
Contractor
901 E SUNFLOWER RD, 901 HWY 8 EAST
CLEVELAND, MS 38732
Ambulance (Land Transport)
901 E SUNFLOWER RD
CLEVELAND, MS 38732
Radiology (Diagnostic Radiology)
901 E SUNFLOWER RD
CLEVELAND, MS 38732
Specialist
901 E SUNFLOWER RD
CLEVELAND, MS 38732

Frequently 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 Phc-Cleveland Inc.'s NPI number?

The NPI number for Phc-Cleveland Inc. is 1316984453. It was assigned to this organization in the NPPES registry on May 31, 2006. The provider is doing business as Bolivar Medical Center Long Term Care Facility.

Where is Phc-Cleveland Inc. located?

Phc-Cleveland Inc. is located at 901 E Sunflower Rd, Cleveland, MS 38732. The listed phone number is (662) 846-0061.

What is Phc-Cleveland Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Phc-Cleveland Inc. 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 Phc-Cleveland Inc. was last updated on March 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.