CMS-1500 Box 24J / 33a • NPI
1063049963
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
310 HOSPITAL AVENUE, JEFFERSON, NC, 28643
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1063049963 (AMANDA DANCY BUNDY, FNP-C) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1063049963)
Medicare Beneficiaries
232
Total Billed Services
964
Distinct CPT/HCPCS Codes
30
Medicare Allowed Total
$48,268.45
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
81003 | Automated urinalysis test | 41 |
90653 | Influenza vaccine, inactivated | 31 |
99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 16 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 264 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 108 |
G0008 | Administration of influenza virus vaccine | 36 |
G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 11 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 105 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 30 | 20 |
| Allopurinol Allopurinol | 21 | <11 |
| Alprazolam Alprazolam | 64 | 15 |
| Amitriptyline Hcl Amitriptyline Hcl | 38 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 107 | 35 |
| Amoxicillin Amoxicillin | 11 | 11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 16 | 16 |
| Aripiprazole Aripiprazole | 18 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1063049963 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AMANDA DANCY BUNDY, FNP-C |
| 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 | 310 HOSPITAL AVENUE, JEFFERSON, NC, 28643 |
| Practice Telephone / Fax | Tel: (336) 846-6322 |
| Administrative Mailing Address | 150 STANLEY BLEVINS RD, LANSING, NC, 28643-9194 |
| Enumeration & Last Sync | Enumerated: 2020-03-23 | CMS Record Updated: 2020-03-24 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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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"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMANDA DANCY BUNDY, FNP-C)
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 |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: NC | License: 5013014 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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