ANGELA RENEE BOONE, NP Adult Geriatric — NPI 1225454507 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health in EDEN, NC)

CMS-1500 Box 24J / 33a • NPI

1225454507

Type 1 Individual Rendering/Ordering

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

405 THOMPSON ST, EDEN, NC, 27288-5045

✓ 9-Digit EDI 837 ZIP+4 (27288-5045)

Practice Phone & Referral Fax

(336) 627-4896

Fax: (336) 627-0139

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1225454507 (ANGELA RENEE BOONE, NP Adult Geriatric) 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

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1225454507` (NPI-1 Individual Practitioner)
Provider / Legal Name	ANGELA RENEE BOONE, NP Adult Geriatric
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	405 THOMPSON ST, EDEN, NC, 27288-5045
Practice Telephone / Fax	Tel: (336) 627-4896 \| Fax: (336) 627-0139
Administrative Mailing Address	405 THOMPSON ST, EDEN, NC, 27288-5045
Enumeration & Last Sync	Enumerated: 2014-03-11 \| CMS Record Updated: 2014-03-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

405 THOMPSON ST, EDEN, NC, 27288-5045

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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"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Adult Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ANGELA RENEE BOONE, NP Adult Geriatric)

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
`363LA2200X` — Nurse Practitioner, Adult Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health	State: NC \| License: `5006739` \| Primary: Yes (Primary)
`364SG0600X` — Clinical Nurse Specialist, Gerontology Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Gerontology	State: NC \| License: `5006739` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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ANGELA RENEE BOONE, NP Adult Geriatric (NPI #1225454507)