AMBULATORY MANAGEMENT LLC — NPI 1003690744 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered in ENTERPRISE, AL)

CMS-1500 Box 24J / 33a • NPI

1003690744

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

367500000X (CMS 43)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered

Box 32 Service Location & ZIP+4

201 E WATTS ST, ENTERPRISE, AL, 36330-1812

✓ 9-Digit EDI 837 ZIP+4 (36330-1812)

Practice Phone & Referral Fax

(334) 393-5474

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003690744 (AMBULATORY MANAGEMENT LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003690744` (NPI-2 Organization / Facility)
Provider / Legal Name	AMBULATORY MANAGEMENT LLC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: `367500000X` (Nurse Anesthetist, Certified Registered)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	201 E WATTS ST, ENTERPRISE, AL, 36330-1812
Practice Telephone / Fax	Tel: (334) 393-5474
Administrative Mailing Address	PO BOX 661495, BIRMINGHAM, AL, 35266-1495
Enumeration & Last Sync	Enumerated: 2023-08-23 \| CMS Record Updated: 2023-08-23
Authorized Official	JOHN JEBELES (Member)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

201 E WATTS ST, ENTERPRISE, AL, 36330-1812

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Plain-English Taxonomy & CMS Crosswalk (367500000X)

What Does Taxonomy Code 367500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 43 (Certified Registered Nurse Anesthetist (CRNA))
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Anesthetist, Certified Registered for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMBULATORY MANAGEMENT LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AMBULATORY MANAGEMENT LLC (NPI #1003690744)