CMS-1500 Box 24J / 33a • NPI
1083560155
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LS0200X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, School
Box 32 Service Location & ZIP+4
251 N BAYOU ST, MOBILE, AL, 36603-5827
✓ 9-Digit EDI 837 ZIP+4 (36603-5827)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1083560155 (JESSICA HARE) 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 | 1083560155 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JESSICA HARE |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, School NUCC Code: 363LS0200X (Nurse Practitioner, School) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 251 N BAYOU ST, MOBILE, AL, 36603-5827 |
| Practice Telephone / Fax | Tel: (251) 690-8158 |
| Administrative Mailing Address | PO BOX 14, JAY, FL, 32565-0014 |
| Enumeration & Last Sync | Enumerated: 2026-03-10 | CMS Record Updated: 2026-03-10 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LS0200X)
What Does Taxonomy Code 363LS0200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LS0200X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, School"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JESSICA HARE)
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 |
|---|---|
363LS0200X — Nurse Practitioner, SchoolPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, School | State: AL | License: 1-127477 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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