CMS-1500 Box 24J / 33a • NPI
1619858644
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LA2100X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Acute Care
Box 32 Service Location & ZIP+4
2120 EXETER RD STE 250, GERMANTOWN, TN, 38138-3931
✓ 9-Digit EDI 837 ZIP+4 (38138-3931)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1619858644 (TONI ANDRADE) 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 | 1619858644 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | TONI ANDRADE |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Acute Care NUCC Code: 363LA2100X (Nurse Practitioner, Acute Care) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2120 EXETER RD STE 250, GERMANTOWN, TN, 38138-3931 |
| Practice Telephone / Fax | Tel: (901) 767-5864 | Fax: (901) 767-6591 |
| Administrative Mailing Address | 350 N HUMPHREYS BLVD, MEMPHIS, TN, 38120-2177 |
| Enumeration & Last Sync | Enumerated: 2025-09-08 | CMS Record Updated: 2025-12-11 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LA2100X)
What Does Taxonomy Code 363LA2100X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LA2100X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Acute Care"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (TONI ANDRADE)
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 |
|---|---|
163WC0200X — Registered Nurse, Critical Care MedicinePlain English: Licensed & Credentialed Registered Nurse, Critical Care Medicine | State: TN | License: 229603 | Primary: Secondary |
363LA2100X — Nurse Practitioner, Acute CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Acute Care | State: MS | License: 907878 | Primary: Secondary |
363LA2100X — Nurse Practitioner, Acute CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Acute Care | State: TN | License: 39914 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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