CMS-1500 Box 24J / 33a • NPI
1366531337
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AM0700X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical
Box 32 Service Location & ZIP+4
3001 W BLUE STARR DR, CLAREMORE, OK, 74017-2544
✓ 9-Digit EDI 837 ZIP+4 (74017-2544)
⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT:
NPI
1366531337 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(2) — Conviction Relating to Patient Abuse or Neglect — Effective 2018-04-19). Verify before submitting Medicare/Medicaid claims.
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1366531337 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KENNETH A ADAMS, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: 363AM0700X (Physician Assistant, Medical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3001 W BLUE STARR DR, CLAREMORE, OK, 74017-2544 |
| Practice Telephone / Fax | Tel: (918) 342-5432 | Fax: (918) 342-0835 |
| Administrative Mailing Address | 2619 GEORGIA AVE, MUSKOGEE, OK, 74403-7670 |
| Enumeration & Last Sync | Enumerated: 2006-10-11 | CMS Record Updated: 2007-07-08 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)
What Does Taxonomy Code 363AM0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KENNETH A ADAMS, PA-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 |
|---|---|
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: OK | License: PA376 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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