CMS-1500 Box 24J / 33a • NPI
1063846699
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208000000X (CMS 37)
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
400 N EASTERN AVE, MOORE, OK, 73160-5833
✓ 9-Digit EDI 837 ZIP+4 (73160-5833)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1063846699 (AKY MD, 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 | 1063846699 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | AKY MD, LLC |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 208000000X (Pediatrics) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 400 N EASTERN AVE, MOORE, OK, 73160-5833 |
| Practice Telephone / Fax | Tel: (405) 757-7818 | Fax: (405) 703-0645 |
| Administrative Mailing Address | PO BOX 891625, OKLAHOMA CITY, OK, 73189-1625 |
| Enumeration & Last Sync | Enumerated: 2013-08-30 | CMS Record Updated: 2025-08-05 |
| Authorized Official | LESLEY HENTHORN (Credentialing) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208000000X)
What Does Taxonomy Code 208000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208000000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AKY MD, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
133V00000X — Dietitian, RegisteredPlain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered | State: N/A | License: Verified | Primary: Secondary |
235Z00000X — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers | State: N/A | License: Verified | Primary: Secondary |
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: N/A | License: Verified | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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