123 BUTTERFLY EFFECTS L.L.C — NPI 1124610092 (Licensed & Credentialed Nurse's Aide in JACKSONVILLE, FL)

CMS-1500 Box 24J / 33a • NPI

1124610092

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

376K00000X

Licensed & Credentialed Nurse's Aide

Box 32 Service Location & ZIP+4

6619 ALBICORE RD, JACKSONVILLE, FL, 32244-1821

✓ 9-Digit EDI 837 ZIP+4 (32244-1821)

Practice Phone & Referral Fax

(770) 776-9567

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124610092 (123 BUTTERFLY EFFECTS L.L.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

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	`1124610092` (NPI-2 Organization / Facility)
Provider / Legal Name	123 BUTTERFLY EFFECTS L.L.C
Plain-English Specialty	Licensed & Credentialed Nurse's Aide NUCC Code: `376K00000X` (Nurse's Aide)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6619 ALBICORE RD, JACKSONVILLE, FL, 32244-1821
Practice Telephone / Fax	Tel: (770) 776-9567
Administrative Mailing Address	6619 ALBICORE RD, JACKSONVILLE, FL, 32244-1821
Enumeration & Last Sync	Enumerated: 2021-02-10 \| CMS Record Updated: 2021-02-10
Authorized Official	JACQUELINE HOLMES (owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6619 ALBICORE RD, JACKSONVILLE, FL, 32244-1821

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Plain-English Taxonomy & CMS Crosswalk (376K00000X)

What Does Taxonomy Code 376K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 376K00000X translates to:
"Licensed & Credentialed Nurse's Aide"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse's Aide for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (123 BUTTERFLY EFFECTS L.L.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

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
`251J00000X` — Nursing Care Plain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)	State: N/A \| License: `Verified` \| Primary: Secondary
`374U00000X` — Home Health Aide Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: N/A \| License: `Verified` \| Primary: Secondary
`376K00000X` — Nurse's Aide Plain English: Licensed & Credentialed Nurse's Aide	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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123 BUTTERFLY EFFECTS L.L.C (NPI #1124610092)