CMS-1500 Box 24J / 33a • NPI
1245940022
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
364SP0808X (CMS 89)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
11911 BOWER RD, MINERVA, OH, 44657-9603
✓ 9-Digit EDI 837 ZIP+4 (44657-9603)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1245940022 (AMORY PSYCHIATRY AND WELLNESS) 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 | 1245940022 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | AMORY PSYCHIATRY AND WELLNESS |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health NUCC Code: 364SP0808X (Clinical Nurse Specialist, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 11911 BOWER RD, MINERVA, OH, 44657-9603 |
| Practice Telephone / Fax | Tel: (330) 205-1168 | Fax: (614) 987-8883 |
| Administrative Mailing Address | 11911 BOWER RD, MINERVA, OH, 44657-9603 |
| Enumeration & Last Sync | Enumerated: 2022-12-01 | CMS Record Updated: 2023-11-30 |
| Authorized Official | AMY COSMA (Owner) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (364SP0808X)
What Does Taxonomy Code 364SP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMORY PSYCHIATRY AND WELLNESS)
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 |
|---|---|
364SP0808X — Clinical Nurse Specialist, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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