84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA. — NPI 1124062112 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal in AUGUSTA, GA)

CMS-1500 Box 24J / 33a • NPI

1124062112

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

363LN0000X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal

Box 32 Service Location & ZIP+4

1350 WALTON WAY, AUGUSTA, GA, 30901-2629

✓ 9-Digit EDI 837 ZIP+4 (30901-2629)

Practice Phone & Referral Fax

(706) 774-8948

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124062112 (84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA.) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1124062112` (NPI-2 Organization / Facility)
Provider / Legal Name	84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA.
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal NUCC Code: `363LN0000X` (Nurse Practitioner, Neonatal)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1350 WALTON WAY, AUGUSTA, GA, 30901-2629
Practice Telephone / Fax	Tel: (706) 774-8948
Administrative Mailing Address	4227 QUAIL SPRINGS CIR, MARTINEZ, GA, 30907-4610
Enumeration & Last Sync	Enumerated: 2006-06-16 \| CMS Record Updated: 2008-06-13
Authorized Official	JOAN HARPER (Neonatal Nures Practitioner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1350 WALTON WAY, AUGUSTA, GA, 30901-2629

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Plain-English Taxonomy & CMS Crosswalk (363LN0000X)

What Does Taxonomy Code 363LN0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LN0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Neonatal for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA.)

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

Common Therapeutic Classes:

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
`363LN0000X` — Nurse Practitioner, Neonatal Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal	State: GA \| License: `RN042192` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA. (NPI #1124062112)