CMS-1500 Box 24J / 33a • NPI
1447231667
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
2109 NAVAJO BLVD, HOLBROOK, AZ, 86025-0000
✓ 9-Digit EDI 837 ZIP+4 (86025-0000)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1447231667 (MARY ANN HENRY, 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1447231667)
Medicare Beneficiaries
89
Total Billed Services
180
Distinct CPT/HCPCS Codes
22
Medicare Allowed Total
$8,500.97
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
80047 | Blood test, basic group of blood chemicals (calcium, ionized) | 11 |
81002 | Urinalysis, manual test | 17 |
85014 | Red blood cell concentration measurement | 11 |
87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 12 |
99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 33 |
99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 30 |
99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 12 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 53 | 51 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 48 | 48 |
| Atrovent Hfa Ipratropium Bromide | 14 | 13 |
| Cefdinir Cefdinir | 24 | 24 |
| Cefpodoxime Proxetil Cefpodoxime Proxetil | 13 | 13 |
| Cephalexin Cephalexin | 62 | 60 |
| Ciprofloxacin Hcl Ciprofloxacin Hcl | 13 | 13 |
| Clindamycin Hcl Clindamycin Hcl | 11 | 11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1447231667 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MARY ANN HENRY, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2109 NAVAJO BLVD, HOLBROOK, AZ, 86025-0000 |
| Practice Telephone / Fax | Tel: (928) 524-2851 | Fax: (928) 524-2171 |
| Administrative Mailing Address | PO BOX 3630, FLAGSTAFF, AZ, 86003-3630 |
| Enumeration & Last Sync | Enumerated: 2005-11-07 | CMS Record Updated: 2011-09-14 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MARY ANN HENRY, 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: AZ | License: 2186 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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