CMS-1500 Box 24J / 33a • NPI
1417546995
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AS0400X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical
Box 32 Service Location & ZIP+4
2000 CIRCLE OF HOPE DR # 1950, SALT LAKE CITY, UT, 84112-5550
✓ 9-Digit EDI 837 ZIP+4 (84112-5550)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1417546995 (HILLARY DAVIS, PA-C) 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 | 1417546995 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HILLARY DAVIS, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical NUCC Code: 363AS0400X (Physician Assistant, Surgical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2000 CIRCLE OF HOPE DR # 1950, SALT LAKE CITY, UT, 84112-5550 |
| Practice Telephone / Fax | Tel: (801) 587-7000 |
| Administrative Mailing Address | 355 MATISSE LN, ALPINE, UT, 84004-1757 |
| Enumeration & Last Sync | Enumerated: 2021-01-11 | CMS Record Updated: 2022-04-08 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AS0400X)
What Does Taxonomy Code 363AS0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AS0400X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HILLARY DAVIS, 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 |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: UT | License: 119690721206 | Primary: Secondary |
363AS0400X — Physician Assistant, SurgicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical | State: UT | License: 1196907-1206 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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