CMS-1500 Box 24J / 33a • NPI
1053011452
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
363LP2300X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care
Box 32 Service Location & ZIP+4
377 W PIKE ST STE A3, LAWRENCEVILLE, GA, 30046-3206
✓ 9-Digit EDI 837 ZIP+4 (30046-3206)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1053011452 (ALIVE HEALTH AND WELLNESS 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1053011452 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ALIVE HEALTH AND WELLNESS LLC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care NUCC Code: 363LP2300X (Nurse Practitioner, Primary Care) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 377 W PIKE ST STE A3, LAWRENCEVILLE, GA, 30046-3206 |
| Practice Telephone / Fax | Tel: (470) 523-5570 |
| Administrative Mailing Address | 377 W PIKE ST STE A3, LAWRENCEVILLE, GA, 30046-3206 |
| Enumeration & Last Sync | Enumerated: 2023-03-06 | CMS Record Updated: 2023-03-24 |
| Authorized Official | ESTHER GENSINGER (Owner/Authorized Official) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP2300X)
What Does Taxonomy Code 363LP2300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP2300X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALIVE HEALTH AND WELLNESS 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
- 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 |
|---|---|
207RI0001X — Internal Medicine, Clinical & Laboratory ImmunologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
363LP2300X — Nurse Practitioner, Primary CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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