CMS-1500 Box 24J / 33a • NPI
1346901865
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
5457 TWIN KNOLLS RD STE 100, COLUMBIA, MD, 21045-3263
✓ 9-Digit EDI 837 ZIP+4 (21045-3263)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1346901865 (AGNES ASHU AGBORTARH) 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 | 1346901865 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AGNES ASHU AGBORTARH |
| 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 | 5457 TWIN KNOLLS RD STE 100, COLUMBIA, MD, 21045-3263 |
| Practice Telephone / Fax | Tel: (410) 689-7400 |
| Administrative Mailing Address | 1232 RACE ROAD, ROSEDALE, MD, 21237-1256 |
| Enumeration & Last Sync | Enumerated: 2022-01-06 | CMS Record Updated: 2024-04-26 |
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 (AGNES ASHU AGBORTARH)
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: MD | License: R216957 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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