J DAVID BARR, PAC — NPI 1679511802 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers

CMS-1500 Box 24J / 33a • NPI

1679511802

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

16734 IVY LAKE DR, ODESSA, FL, 33556-6020

✓ 9-Digit EDI 837 ZIP+4 (33556-6020)

Practice Phone & Referral Fax

(813) 459-7711

Fax: (813) 235-4175

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1679511802 (J DAVID BARR, PAC) 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	`1679511802` (NPI-1 Individual Practitioner)
Provider / Legal Name	J DAVID BARR, PAC
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	16734 IVY LAKE DR, ODESSA, FL, 33556-6020
Practice Telephone / Fax	Tel: (813) 459-7711 \| Fax: (813) 235-4175
Administrative Mailing Address	18865 STATE ROAD 54 # 301, LUTZ, FL, 33558-8201
Enumeration & Last Sync	Enumerated: 2006-06-02 \| CMS Record Updated: 2018-09-04

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

16734 IVY LAKE DR, ODESSA, FL, 33556-6020

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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"

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 for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (J DAVID BARR, PAC)

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
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: ZZ \| License: `PA9108698` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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J DAVID BARR, PAC (NPI #1679511802)