CMS-1500 Box 24J / 33a • NPI
1336339035
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367H00000X (CMS 32)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant
Box 32 Service Location & ZIP+4
677 CHURCH ST NE, MARIETTA, GA, 30060-1101
✓ 9-Digit EDI 837 ZIP+4 (30060-1101)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1336339035 (GLORIA CHAFFIN) 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
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1336339035)
Medicare Beneficiaries
66
Total Billed Services
67
Distinct CPT/HCPCS Codes
12
Medicare Allowed Total
$4,994.11
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
00142 | Anesthesia for lens surgery | 28 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1336339035 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | GLORIA CHAFFIN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant NUCC Code: 367H00000X (Anesthesiologist Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 677 CHURCH ST NE, MARIETTA, GA, 30060-1101 |
| Practice Telephone / Fax | Tel: (770) 794-0477 | Fax: (770) 794-3108 |
| Administrative Mailing Address | 4922 STARVILLE RD, CHINA, MI, 48054-3021 |
| Enumeration & Last Sync | Enumerated: 2007-07-29 | CMS Record Updated: 2022-12-07 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (367H00000X)
What Does Taxonomy Code 367H00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367H00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GLORIA CHAFFIN)
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 |
|---|---|
367H00000X — Anesthesiologist AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant | State: GA | License: Verified | Primary: Secondary |
367H00000X — Anesthesiologist AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant | State: OH | License: 67.000341 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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