CMS-1500 Box 24J / 33a • NPI
1528798261
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363L00000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner
Box 32 Service Location & ZIP+4
2131 E STATE ST, ATHENS, OH, 45701-2138
✓ 9-Digit EDI 837 ZIP+4 (45701-2138)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1528798261 (COURTNEY MICHELLE ABFALL, FNP-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 #1528798261)
Medicare Beneficiaries
255
Total Billed Services
612
Distinct CPT/HCPCS Codes
10
Medicare Allowed Total
$29,980.68
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 28 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 13 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 286 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 123 |
99441 | Telephone medical discussion with physician, 5-10 minutes | 11 |
G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 143 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Budesonide Ec Budesonide | 13 | <11 |
| Colestipol Hcl Colestipol Hcl | 76 | 18 |
| Constulose Lactulose | 65 | 31 |
| Creon Lipase/Protease/Amylase | 17 | <11 |
| Esomeprazole Magnesium Esomeprazole Magnesium | 27 | <11 |
| Famotidine Famotidine | 183 | 47 |
| Furosemide Furosemide | 19 | <11 |
| Gavilyte-G Peg3350/Sod Sulf,bicarb,cl/Kcl | 103 | 102 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1528798261 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | COURTNEY MICHELLE ABFALL, FNP-C |
| 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 | 2131 E STATE ST, ATHENS, OH, 45701-2138 |
| Practice Telephone / Fax | Tel: (855) 446-5937 | Fax: (740) 566-4013 |
| Administrative Mailing Address | 100 JACKSON PIKE, GALLIPOLIS, OH, 45631-1560 |
| Enumeration & Last Sync | Enumerated: 2022-06-15 | CMS Record Updated: 2025-04-22 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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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"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (COURTNEY MICHELLE ABFALL, FNP-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 |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: OH | License: RN.416479 | Primary: Secondary |
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: OH | License: APRN.CNP.0031806 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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