CMS-1500 Box 24J / 33a • NPI
1205948197
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AM0700X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical
Box 32 Service Location & ZIP+4
515 CARLTON STREET, PIONEER MEDICAL CENTER, WAUCHULA, FL, 33873
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1205948197 (LAUREN MARIE CANARY, PA) 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 | 1205948197 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | LAUREN MARIE CANARY, PA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: 363AM0700X (Physician Assistant, Medical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 515 CARLTON STREET, PIONEER MEDICAL CENTER, WAUCHULA, FL, 33873 |
| Practice Telephone / Fax | Tel: (863) 773-6606 | Fax: (863) 773-9542 |
| Administrative Mailing Address | 515 CARLTON STREET, WAUCHULA, FL, 33873 |
| Enumeration & Last Sync | Enumerated: 2006-08-31 | CMS Record Updated: 2013-08-28 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)
What Does Taxonomy Code 363AM0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LAUREN MARIE CANARY, PA)
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 |
|---|---|
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: FL | License: PA9101695 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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