LARRY BETTELEY, RN — NPI 1366165037 (Licensed & Credentialed Hospitals

CMS-1500 Box 24J / 33a • NPI

1366165037

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

286500000X (CMS A0[7])

Licensed & Credentialed Hospitals — Military Hospital

Box 32 Service Location & ZIP+4

4646 JOHN R ST, DETROIT, MI, 48201-1916

✓ 9-Digit EDI 837 ZIP+4 (48201-1916)

Practice Phone & Referral Fax

(313) 576-1000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366165037 (LARRY BETTELEY, RN) 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	`1366165037` (NPI-1 Individual Practitioner)
Provider / Legal Name	LARRY BETTELEY, RN
Plain-English Specialty	Licensed & Credentialed Hospitals — Military Hospital NUCC Code: `286500000X` (Military Hospital)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	4646 JOHN R ST, DETROIT, MI, 48201-1916
Practice Telephone / Fax	Tel: (313) 576-1000
Administrative Mailing Address	PO BOX 313, FLAT ROCK, MI, 48134-0313
Enumeration & Last Sync	Enumerated: 2022-09-19 \| CMS Record Updated: 2022-10-20

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4646 JOHN R ST, DETROIT, MI, 48201-1916

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Plain-English Taxonomy & CMS Crosswalk (286500000X)

What Does Taxonomy Code 286500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 286500000X translates to:
"Licensed & Credentialed Hospitals — Military Hospital"

CMS-1500 Medicare Specialty Crosswalk: CMS Code A0[7] (Hospitals)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Military Hospital for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LARRY BETTELEY, RN)

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
`286500000X` — Military Hospital Plain English: Licensed & Credentialed Hospitals — Military Hospital	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LARRY BETTELEY, RN (NPI #1366165037)