JUSTIN COLIN EVERSON, MMS, PA-C — NPI 1457604944 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical in LUTHERVILLE, MD)

CMS-1500 Box 24J / 33a • NPI

1457604944

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

10755 FALLS RD STE 160, LUTHERVILLE, MD, 21093-4588

✓ 9-Digit EDI 837 ZIP+4 (21093-4588)

Practice Phone & Referral Fax

(410) 583-2777

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1457604944 (JUSTIN COLIN EVERSON, MMS, 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

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1457604944` (NPI-1 Individual Practitioner)
Provider / Legal Name	JUSTIN COLIN EVERSON, MMS, 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	10755 FALLS RD STE 160, LUTHERVILLE, MD, 21093-4588
Practice Telephone / Fax	Tel: (410) 583-2777
Administrative Mailing Address	BUILDING 19H, ROOM 270, PERRY POINT, MD, 21902
Enumeration & Last Sync	Enumerated: 2012-10-21 \| CMS Record Updated: 2023-11-28

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10755 FALLS RD STE 160, LUTHERVILLE, MD, 21093-4588

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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"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 97 (Physician Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physician Assistant, Medical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JUSTIN COLIN EVERSON, MMS, 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

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
`207RA0401X` — Internal Medicine, Addiction Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: MD \| License: `C0004855` \| Primary: Secondary
`363AM0700X` — Physician Assistant, Medical Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical	State: MD \| License: `C0004855` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JUSTIN COLIN EVERSON, MMS, PA-C (NPI #1457604944)