CMS-1500 Box 24J / 33a • NPI
1154652618
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
363LA2200X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health
Box 32 Service Location & ZIP+4
3295 E CAUSEWAY APPROACH, MANDEVILLE, LA, 70448-3451
✓ 9-Digit EDI 837 ZIP+4 (70448-3451)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1154652618 (ADVANCED DERMATOLOGY & FAMILY HEALTH CARE WALK-IN & WELLNESS CLINICLLC) 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 | 1154652618 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED DERMATOLOGY & FAMILY HEALTH CARE WALK-IN & WELLNESS CLINICLLC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health NUCC Code: 363LA2200X (Nurse Practitioner, Adult Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3295 E CAUSEWAY APPROACH, MANDEVILLE, LA, 70448-3451 |
| Practice Telephone / Fax | Tel: (985) 674-1481 | Fax: (985) 626-6956 |
| Administrative Mailing Address | 3295 E CAUSEWAY APPROACH, MANDEVILLE, LA, 70448-3451 |
| Enumeration & Last Sync | Enumerated: 2010-01-22 | CMS Record Updated: 2010-08-31 |
| Authorized Official | MELISSA BROWN (Adult Nurse Practitioner/CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LA2200X)
What Does Taxonomy Code 363LA2200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LA2200X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED DERMATOLOGY & FAMILY HEALTH CARE WALK-IN & WELLNESS CLINICLLC)
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 |
|---|---|
363LA2200X — Nurse Practitioner, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health | State: LA | License: AP05770 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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