CMS-1500 Box 24J / 33a • NPI
1104366038
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363L00000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner
Box 32 Service Location & ZIP+4
214 E ELM ST, GRAHAM, NC, 27253-3022
✓ 9-Digit EDI 837 ZIP+4 (27253-3022)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1104366038 (JOLENE TADZIA CANNADY, AGPCNP-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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1104366038 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JOLENE TADZIA CANNADY, AGPCNP-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: 363L00000X (Nurse Practitioner) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 214 E ELM ST, GRAHAM, NC, 27253-3022 |
| Practice Telephone / Fax | Tel: (336) 226-2448 | Fax: (336) 226-5894 |
| Administrative Mailing Address | 4007 LAUDER LN, BURLINGTON, NC, 27215-9499 |
| Enumeration & Last Sync | Enumerated: 2017-02-25 | CMS Record Updated: 2026-04-13 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
🗺️ Open in Google Maps 🏥 More Providers in GRAHAM
🔒 Are you JOLENE TADZIA CANNADY, AGPCNP-C? Get your Verified NPI Clinic Badge or request personal phone/address redaction →
Plain-English Taxonomy & CMS Crosswalk (363L00000X)
What Does Taxonomy Code 363L00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JOLENE TADZIA CANNADY, AGPCNP-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 |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: NC | License: 5009267 | Primary: Yes (Primary) |
363LA2200X — Nurse Practitioner, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health | State: NC | License: 5009267 | Primary: Secondary |
363LG0600X — Nurse Practitioner, GerontologyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology | State: NC | License: 5009267 | Primary: Secondary |
363LP2300X — Nurse Practitioner, Primary CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care | State: NC | License: 5009267 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.