ABILENE FAMILY MEDICAL CLINIC, LLC — NPI 1376954743 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers

CMS-1500 Box 24J / 33a • NPI

1376954743

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

363L00000X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner

Box 32 Service Location & ZIP+4

4542 S 14TH ST, ABILENE, TX, 79605-4737

✓ 9-Digit EDI 837 ZIP+4 (79605-4737)

Practice Phone & Referral Fax

(325) 701-9961

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1376954743 (ABILENE FAMILY MEDICAL CLINIC, LLC) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1376954743` (NPI-2 Organization / Facility)
Provider / Legal Name	ABILENE FAMILY MEDICAL CLINIC, LLC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: `363L00000X` (Nurse Practitioner)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	4542 S 14TH ST, ABILENE, TX, 79605-4737
Practice Telephone / Fax	Tel: (325) 701-9961
Administrative Mailing Address	4542 S 14TH ST, ABILENE, TX, 79605-4737
Enumeration & Last Sync	Enumerated: 2014-05-19 \| CMS Record Updated: 2014-05-19
Authorized Official	FREDDIE JOHNSON (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4542 S 14TH ST, ABILENE, TX, 79605-4737

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Plain-English Taxonomy & CMS Crosswalk (363L00000X)

What Does Taxonomy Code 363L00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ABILENE FAMILY MEDICAL CLINIC, LLC)

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
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: TX \| License: `603150` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ABILENE FAMILY MEDICAL CLINIC, LLC (NPI #1376954743)