CMS-1500 Box 24J / 33a • NPI
1255398400
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207R00000X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
805 W CENTERTON BLVD, CENTERTON, AR, 72719-9705
✓ 9-Digit EDI 837 ZIP+4 (72719-9705)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1255398400 (LANCE A FADDIS, MD) 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
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1255398400)
Medicare Beneficiaries
134
Total Billed Services
829
Distinct CPT/HCPCS Codes
37
Medicare Allowed Total
$36,571.34
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
36415 | Insertion of needle into vein for collection of blood sample | 79 |
71046 | X-ray of chest, 2 views | 11 |
90662 | Influenza vaccine split virus, preservative free | 12 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 49 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 123 |
G0008 | Administration of influenza virus vaccine | 12 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 19 |
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 | 30 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1255398400 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | LANCE A FADDIS, MD |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207R00000X (Internal Medicine) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 805 W CENTERTON BLVD, CENTERTON, AR, 72719-9705 |
| Practice Telephone / Fax | Tel: (479) 795-1301 | Fax: (479) 795-1304 |
| Administrative Mailing Address | 805 W CENTERTON BLVD, CENTERTON, AR, 72719-9705 |
| Enumeration & Last Sync | Enumerated: 2006-04-28 | CMS Record Updated: 2011-12-02 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207R00000X)
What Does Taxonomy Code 207R00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207R00000X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LANCE A FADDIS, MD)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: AR | License: E3957 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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