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PHC-CLEVELAND LLC
NPI 1528158532
Anesthesiology in Cleveland, MS

Active since October 13, 2006
901 E SUNFLOWER RD, CLEVELAND, MS 38732(662) 846-0061(662) 846-5680 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 5, 2020, Sep 9, 2019, May 31, 2017 (3 updates tracked since 2017).

About Phc-cleveland Llc NPPES

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

PHC-CLEVELAND LLC (NPI 1528158532), doing business as Bolivar Medical Center, is a healthcare organization registered as an anesthesiology in Cleveland, Mississippi and active in the NPI registry since October 2006. The organization lists Johnetta Traylor, Administrator, as its authorized official.

NPPES Registry Identity

NPI1528158532
Entity TypeOrganization
Primary Taxonomy207L00000X
Legal Business NamePHC-CLEVELAND LLC
Location Address901 E SUNFLOWER RDCleveland, MS 38732-2833
Mailing Address901 E Sunflower RdCleveland, MS 38732-2833 · (662) 846-0061 · Fax (662) 846-2277
Phone(662) 846-0061
Fax(662) 846-5680
Organization SubpartNo
Authorized OfficialJohnetta TraylorAdministrator · (502) 596-6063
Enumeration DateOctober 13, 2006
Last NPPES UpdateSeptember 22, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2025
✔ NPI 1528158532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedRadiology · Body ImagingTaxonomy 2085B0100X
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X
Also ListedNurse Anesthetist, Certified RegisteredTaxonomy 367500000X
901 E SUNFLOWER RD, Cleveland, MS 38732
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Other Names 1

Doing Business AsBolivar Medical Center

Other Identifiers 1

Medicaid9015261MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phc-cleveland Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Phc-Cleveland LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Steven Clark, M.D
Internal Medicine
NPI 1053408476
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Andrew Lott, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1982864930
121 E BAKER ST
Indianola, MS 38751
(662) 887-5235
✔ PECOS✔ Accepts Medicare20 mi
Michelle Lowery, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1972819100
1400 E UNION ST
Greenville, MS 38703
(662) 378-3783
✔ PECOS✔ Accepts Medicare30 mi
Gregory Hurd, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1225054422
830 SOUTH GLOSTER
Tupelo, MS 38801
(662) 377-4394
✔ PECOS✔ Accepts Medicare119 mi
Neal Dupre, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1699766493
105 BLUE RIDGE DR
Carencro, LA 70520
(337) 896-9639
✔ PECOS245 mi
Omar Salam, M.D.
Obstetrics/Gynecology
NPI 1376777995
500 J CLYDE MORRIS BLVD RIVERSIDE REGIONAL MEDICAL CENTER
Newport News, VA 23601
(757) 594-4737
✔ PECOS834 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 LLC's NPI number?

The NPI number for Phc-Cleveland LLC is 1528158532. It was assigned to this organization in the NPPES registry on October 13, 2006. The provider is doing business as Bolivar Medical Center.

Where is Phc-Cleveland LLC located?

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

What is Phc-Cleveland LLC's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Phc-Cleveland LLC enrolled in Medicare?

Yes. Phc-Cleveland LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Phc-Cleveland LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Phc-Cleveland LLC. 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. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (4), Internal Medicine (1) and Obstetrics/Gynecology (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Phc-Cleveland LLC was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.