ADVANCED HEALTH REVISION PLLC — NPI 1235813114 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology in ARLINGTON, TX)

CMS-1500 Box 24J / 33a • NPI

1235813114

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

363LG0600X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology

Box 32 Service Location & ZIP+4

4201 INTERWAY PL, ARLINGTON, TX, 76018-5668

✓ 9-Digit EDI 837 ZIP+4 (76018-5668)

Practice Phone & Referral Fax

(972) 978-2317

Fax: (800) 782-4295

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1235813114 (ADVANCED HEALTH REVISION PLLC) 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	`1235813114` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED HEALTH REVISION PLLC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology NUCC Code: `363LG0600X` (Nurse Practitioner, Gerontology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	4201 INTERWAY PL, ARLINGTON, TX, 76018-5668
Practice Telephone / Fax	Tel: (972) 978-2317 \| Fax: (800) 782-4295
Administrative Mailing Address	661 E MAIN ST STE 200, MIDLOTHIAN, TX, 76065-3365
Enumeration & Last Sync	Enumerated: 2023-06-12 \| CMS Record Updated: 2026-04-15
Authorized Official	KIMBERLY NEELY (Owner / Nurse Practitioner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4201 INTERWAY PL, ARLINGTON, TX, 76018-5668

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Plain-English Taxonomy & CMS Crosswalk (363LG0600X)

What Does Taxonomy Code 363LG0600X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LG0600X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology"

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, Gerontology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED HEALTH REVISION PLLC)

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
`363LG0600X` — Nurse Practitioner, Gerontology Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED HEALTH REVISION PLLC (NPI #1235813114)