CMS-1500 Box 24J / 33a • NPI
1104207125
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
35 HOSPITAL RD, BLAIRSVILLE, GA, 30512-3139
✓ 9-Digit EDI 837 ZIP+4 (30512-3139)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1104207125 (WILLIAM KYLE CODY, PA-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 #1104207125)
Medicare Beneficiaries
555
Total Billed Services
868
Distinct CPT/HCPCS Codes
22
Medicare Allowed Total
$65,831.81
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
12002 | Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | 11 |
93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 366 |
99283 | Emergency department visit with low level of medical decision making | 11 |
99284 | Emergency department visit with moderate level of medical decision making | 138 |
99285 | Emergency department visit with high level of medical decision making | 216 |
99291 | Critical care, first 30-74 minutes | 86 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 27 | 27 |
| Azithromycin Azithromycin | 36 | 35 |
| Cefdinir Cefdinir | 86 | 82 |
| Cefuroxime Cefuroxime Axetil | 14 | 13 |
| Cephalexin Cephalexin | 70 | 67 |
| Ciprofloxacin Hcl Ciprofloxacin Hcl | 53 | 52 |
| Dexamethasone Dexamethasone | 11 | 11 |
| Diclofenac Potassium Diclofenac Potassium | 34 | 33 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1104207125 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | WILLIAM KYLE CODY, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 35 HOSPITAL RD, BLAIRSVILLE, GA, 30512-3139 |
| Practice Telephone / Fax | Tel: (706) 439-6432 |
| Administrative Mailing Address | 52 RUEL HALL RD, HAYESVILLE, NC, 28904-7108 |
| Enumeration & Last Sync | Enumerated: 2015-06-16 | CMS Record Updated: 2026-05-29 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (WILLIAM KYLE CODY, PA-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 |
|---|---|
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: GA | License: 9769 | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: NC | License: 0010-05788 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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