AGAPE WOUND CARE LLC — NPI 1124818026 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers

CMS-1500 Box 24J / 33a • NPI

1124818026

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

363A00000X (CMS 97)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant

Box 32 Service Location & ZIP+4

9556 PARK MEADOWS DR STE 300, LONE TREE, CO, 80124-5339

✓ 9-Digit EDI 837 ZIP+4 (80124-5339)

Practice Phone & Referral Fax

(720) 654-4221

Fax: (720) 596-5254

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124818026 (AGAPE WOUND CARE LLC) 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	`1124818026` (NPI-2 Organization / Facility)
Provider / Legal Name	AGAPE WOUND CARE LLC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: `363A00000X` (Physician Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	9556 PARK MEADOWS DR STE 300, LONE TREE, CO, 80124-5339
Practice Telephone / Fax	Tel: (720) 654-4221 \| Fax: (720) 596-5254
Administrative Mailing Address	4466 DUSTY PINE TRL, CASTLE ROCK, CO, 80109-7717
Enumeration & Last Sync	Enumerated: 2025-05-12 \| CMS Record Updated: 2025-08-01
Authorized Official	JILLIAN JUST (OWNER)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

9556 PARK MEADOWS DR STE 300, LONE TREE, CO, 80124-5339

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Plain-English Taxonomy & CMS Crosswalk (363A00000X)

What Does Taxonomy Code 363A00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 97 (Physician Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physician Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AGAPE WOUND CARE LLC)

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
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AGAPE WOUND CARE LLC (NPI #1124818026)