CMS-1500 Box 24J / 33a • NPI
1639774722
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
163WD0400X
Licensed & Credentialed Registered Nurse, Diabetes Educator
Box 32 Service Location & ZIP+4
1400 W 43RD AVE, PINE BLUFF, AR, 71603-7010
✓ 9-Digit EDI 837 ZIP+4 (71603-7010)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639774722 (AJ'S HEALTH & WELLNESS ENTERPRISES PLLC) 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 | 1639774722 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | AJ'S HEALTH & WELLNESS ENTERPRISES PLLC |
| Plain-English Specialty | Licensed & Credentialed Registered Nurse, Diabetes Educator NUCC Code: 163WD0400X (Registered Nurse, Diabetes Educator) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1400 W 43RD AVE, PINE BLUFF, AR, 71603-7010 |
| Practice Telephone / Fax | Tel: (870) 413-9968 | Fax: (870) 535-0594 |
| Administrative Mailing Address | 1400 W 43RD AVE, PINE BLUFF, AR, 71603-7010 |
| Enumeration & Last Sync | Enumerated: 2020-12-04 | CMS Record Updated: 2020-12-04 |
| Authorized Official | ASHLEY JAMES (CEO/President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (163WD0400X)
What Does Taxonomy Code 163WD0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WD0400X translates to:
"Licensed & Credentialed Registered Nurse, Diabetes Educator"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AJ'S HEALTH & WELLNESS ENTERPRISES PLLC)
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 |
|---|---|
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Secondary |
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: N/A | License: Verified | Primary: Secondary |
364SA2100X — Clinical Nurse Specialist, Acute CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Acute Care | State: N/A | License: Verified | Primary: Secondary |
364SC0200X — Clinical Nurse Specialist, Critical Care MedicinePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Critical Care Medicine | State: N/A | License: Verified | Primary: Secondary |
163WD0400X — Registered Nurse, Diabetes EducatorPlain English: Licensed & Credentialed Registered Nurse, Diabetes Educator | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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