CMS-1500 Box 24J / 33a • NPI
1184028656
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363L00000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner
Box 32 Service Location & ZIP+4
215 E MANSION ST STE 1E, MARSHALL, MI, 49068-1167
✓ 9-Digit EDI 837 ZIP+4 (49068-1167)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184028656 (JENNIFER BURNHAM) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1184028656)
Medicare Beneficiaries
140
Total Billed Services
767
Distinct CPT/HCPCS Codes
21
Medicare Allowed Total
$40,190.81
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 142 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 165 |
99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 47 |
99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 80 |
99497 | Advance care planning, first 30 minutes | 18 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 75 |
G0444 | Annual depression screening, 5 to 15 minutes | 57 |
G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 107 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 69 | 26 |
| Alendronate Sodium Alendronate Sodium | 33 | <11 |
| Allopurinol Allopurinol | 33 | 11 |
| Alprazolam Alprazolam | 91 | 23 |
| Amitriptyline Hcl Amitriptyline Hcl | 25 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 209 | 58 |
| Amlodipine Besylate-Benazepril Amlodipine Besylate/Benazepril | 20 | <11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 16 | 15 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184028656 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JENNIFER BURNHAM |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: 363L00000X (Nurse Practitioner) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 215 E MANSION ST STE 1E, MARSHALL, MI, 49068-1167 |
| Practice Telephone / Fax | Tel: (269) 781-3938 |
| Administrative Mailing Address | 215 E MANSION ST STE 1E, MARSHALL, MI, 49068-1167 |
| Enumeration & Last Sync | Enumerated: 2014-10-13 | CMS Record Updated: 2019-12-16 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (363L00000X)
What Does Taxonomy Code 363L00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JENNIFER BURNHAM)
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 |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: MI | License: 4704241030 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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