CMS-1500 Box 24J / 33a • NPI
1316588668
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
3940 ARROWHEAD BLVD STE 110, MEBANE, NC, 27302-7637
✓ 9-Digit EDI 837 ZIP+4 (27302-7637)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1316588668 (KOMLANVI SEDO AVEGNO, DNP, APRN, FNP-C) 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 | 1316588668 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KOMLANVI SEDO AVEGNO, DNP, APRN, FNP-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3940 ARROWHEAD BLVD STE 110, MEBANE, NC, 27302-7637 |
| Practice Telephone / Fax | Tel: (336) 832-8040 |
| Administrative Mailing Address | 1123 N CHURCH ST, GREENSBORO, NC, 27401-1007 |
| Enumeration & Last Sync | Enumerated: 2019-10-07 | CMS Record Updated: 2021-08-10 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KOMLANVI SEDO AVEGNO, DNP, APRN, FNP-C)
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 |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: CT | License: 8531 | Primary: Secondary |
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: NC | License: 5013420 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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