CMS-1500 Box 24J / 33a • NPI
1104783034
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
171M00000X
Licensed & Credentialed Case Manager/Care Coordinator
Box 32 Service Location & ZIP+4
120 45TH ST NE APT 528, WASHINGTON, DC, 20019-4773
✓ 9-Digit EDI 837 ZIP+4 (20019-4773)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1104783034 (TAMIKA LYNN BRUCE) 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 | 1104783034 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | TAMIKA LYNN BRUCE |
| Plain-English Specialty | Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: 171M00000X (Case Manager/Care Coordinator) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 120 45TH ST NE APT 528, WASHINGTON, DC, 20019-4773 |
| Practice Telephone / Fax | Tel: (202) 300-7478 |
| Administrative Mailing Address | 25227 TRALEE CT, DAMASCUS, MD, 20872-2723 |
| Enumeration & Last Sync | Enumerated: 2026-01-05 | CMS Record Updated: 2026-06-29 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (171M00000X)
What Does Taxonomy Code 171M00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (TAMIKA LYNN BRUCE)
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 |
|---|---|
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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