LORI DAWN EDENFIELD, ARNP BC — NPI 1003907957 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family in CHIPLEY, FL)

CMS-1500 Box 24J / 33a • NPI

1003907957

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LF0000X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family

Box 32 Service Location & ZIP+4

1410 BRICKYARD RD, SAMUEL E WARD MD PL, CHIPLEY, FL, 32428

Official NPPES Practice Location

Practice Phone & Referral Fax

(850) 638-3400

Fax: (850) 638-9611

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1003907957 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(1) — Conviction of Program-Related Crimes (Mandatory 5-Yr Min) — Effective 2022-12-20). Verify before submitting Medicare/Medicaid claims.

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003907957` (NPI-1 Individual Practitioner)
Provider / Legal Name	LORI DAWN EDENFIELD, ARNP BC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: `363LF0000X` (Nurse Practitioner, Family)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1410 BRICKYARD RD, SAMUEL E WARD MD PL, CHIPLEY, FL, 32428
Practice Telephone / Fax	Tel: (850) 638-3400 \| Fax: (850) 638-9611
Administrative Mailing Address	1410 BRICKYARD RD, CHIPLEY, FL, 32428
Enumeration & Last Sync	Enumerated: 2006-09-27 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1410 BRICKYARD RD, SAMUEL E WARD MD PL, CHIPLEY, FL, 32428

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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)

What Does Taxonomy Code 363LF0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Family for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LORI DAWN EDENFIELD, ARNP BC)

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
`363LF0000X` — Nurse Practitioner, Family Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family	State: FL \| License: `ARNP3139042` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LORI DAWN EDENFIELD, ARNP BC (NPI #1003907957)