BENNDALE ELEMENTARY SCHOOL — NPI 1376973057 (Licensed & Credentialed Student in an Organized Health Care Education/Training Program in LUCEDALE, MS)

CMS-1500 Box 24J / 33a • NPI

1376973057

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

390200000X

Licensed & Credentialed Student in an Organized Health Care Education/Training Program

Box 32 Service Location & ZIP+4

5204 HIGHWAY 26 W, LUCEDALE, MS, 39452-2383

✓ 9-Digit EDI 837 ZIP+4 (39452-2383)

Practice Phone & Referral Fax

(601) 766-6341

Fax: (601) 945-2938

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1376973057 (BENNDALE ELEMENTARY SCHOOL) 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	`1376973057` (NPI-2 Organization / Facility)
Provider / Legal Name	BENNDALE ELEMENTARY SCHOOL
Plain-English Specialty	Licensed & Credentialed Student in an Organized Health Care Education/Training Program NUCC Code: `390200000X` (Student in an Organized Health Care Education/Training Program)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5204 HIGHWAY 26 W, LUCEDALE, MS, 39452-2383
Practice Telephone / Fax	Tel: (601) 766-6341 \| Fax: (601) 945-2938
Administrative Mailing Address	5204 HIGHWAY 26 W, LUCEDALE, MS, 39452-2383
Enumeration & Last Sync	Enumerated: 2013-11-18 \| CMS Record Updated: 2013-11-18
Authorized Official	JODI SUMRALL (School Nurse)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5204 HIGHWAY 26 W, LUCEDALE, MS, 39452-2383

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Plain-English Taxonomy & CMS Crosswalk (390200000X)

What Does Taxonomy Code 390200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 390200000X translates to:
"Licensed & Credentialed Student in an Organized Health Care Education/Training Program"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Student in an Organized Health Care Education/Training Program for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BENNDALE ELEMENTARY SCHOOL)

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
`390200000X` — Student in an Organized Health Care Education/Training Program Plain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program	State: MS \| License: `R872149` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BENNDALE ELEMENTARY SCHOOL (NPI #1376973057)