CMS-1500 Box 24J / 33a • NPI
1114500931
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367500000X (CMS 43)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered
Box 32 Service Location & ZIP+4
225 E JACKSON AVE, JONESBORO, AR, 72401-3119
✓ 9-Digit EDI 837 ZIP+4 (72401-3119)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1114500931 (HANNAH BROOKE AGUDELO) 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
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1114500931)
Medicare Beneficiaries
119
Total Billed Services
130
Distinct CPT/HCPCS Codes
45
Medicare Allowed Total
$27,214.37
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
01402 | Anesthesia for procedure for total knee joint replacement | 14 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1114500931 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HANNAH BROOKE AGUDELO |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: 367500000X (Nurse Anesthetist, Certified Registered) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 225 E JACKSON AVE, JONESBORO, AR, 72401-3119 |
| Practice Telephone / Fax | Tel: (870) 207-4100 |
| Administrative Mailing Address | 4300 AGGIE RD APT 20, JONESBORO, AR, 72405-9795 |
| Enumeration & Last Sync | Enumerated: 2021-04-29 | CMS Record Updated: 2021-07-30 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (367500000X)
What Does Taxonomy Code 367500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HANNAH BROOKE AGUDELO)
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 |
|---|---|
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: AR | License: 216251 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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