JONATHAN MURDAUGH — NPI 1275923484 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1275923484

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TC1900X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling

Box 32 Service Location & ZIP+4

1040 TINKER TOWN RD, FAIRFAX, SC, 29827-7220

✓ 9-Digit EDI 837 ZIP+4 (29827-7220)

Practice Phone & Referral Fax

(803) 686-0412

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1275923484 (JONATHAN MURDAUGH) 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	`1275923484` (NPI-1 Individual Practitioner)
Provider / Legal Name	JONATHAN MURDAUGH
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling NUCC Code: `103TC1900X` (Psychologist, Counseling)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1040 TINKER TOWN RD, FAIRFAX, SC, 29827-7220
Practice Telephone / Fax	Tel: (803) 686-0412
Administrative Mailing Address	PO BOX 1332, FAIRFAX, SC, 29827-1332
Enumeration & Last Sync	Enumerated: 2015-01-26 \| CMS Record Updated: 2015-01-28

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1040 TINKER TOWN RD, FAIRFAX, SC, 29827-7220

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Plain-English Taxonomy & CMS Crosswalk (103TC1900X)

What Does Taxonomy Code 103TC1900X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC1900X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Counseling for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JONATHAN MURDAUGH)

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
`103TC1900X` — Psychologist, Counseling Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: N/A \| License: `Verified` \| Primary: Secondary
`103TR0400X` — Psychologist, Rehabilitation Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Rehabilitation	State: N/A \| License: `Verified` \| Primary: Secondary

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JONATHAN MURDAUGH (NPI #1275923484)