JERRY E BOTTS, PHARM D — NPI 1023065521 (Licensed & Credentialed Pharmacist in CARL JUNCTION, MO)

CMS-1500 Box 24J / 33a • NPI

1023065521

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

183500000X

Licensed & Credentialed Pharmacist

Box 32 Service Location & ZIP+4

102 S MAIN ST, CARL JUNCTION, MO, 64834-1000

✓ 9-Digit EDI 837 ZIP+4 (64834-1000)

Practice Phone & Referral Fax

(417) 649-7021

Direct NPPES Verification Line

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1023065521 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 2019-04-18). 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	`1023065521` (NPI-1 Individual Practitioner)
Provider / Legal Name	JERRY E BOTTS, PHARM D
Plain-English Specialty	Licensed & Credentialed Pharmacist NUCC Code: `183500000X` (Pharmacist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	102 S MAIN ST, CARL JUNCTION, MO, 64834-1000
Practice Telephone / Fax	Tel: (417) 649-7021
Administrative Mailing Address	131 FOREST DR, CARL JUNCTION, MO, 64834-9613
Enumeration & Last Sync	Enumerated: 2006-05-28 \| CMS Record Updated: 2026-07-13

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

102 S MAIN ST, CARL JUNCTION, MO, 64834-1000

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Plain-English Taxonomy & CMS Crosswalk (183500000X)

What Does Taxonomy Code 183500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JERRY E BOTTS, PHARM D)

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
`183500000X` — Pharmacist Plain English: Licensed & Credentialed Pharmacist	State: MO \| License: `044270` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JERRY E BOTTS, PHARM D (NPI #1023065521)