CMS-1500 Box 24J / 33a • NPI
1780985325
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
183500000X
Licensed & Credentialed Pharmacist
Box 32 Service Location & ZIP+4
346 STATE ROUTE 58 E, CLINTON, KY, 42031-9425
✓ 9-Digit EDI 837 ZIP+4 (42031-9425)
⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT:
NPI
1780985325 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(1) — Conviction of Program-Related Crimes (Mandatory 5-Yr Min) — Effective 2026-10-20). Verify before submitting Medicare/Medicaid claims.
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1780985325 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MICHAEL SHAWN BOAZ, r.ph |
| Plain-English Specialty | Licensed & Credentialed Pharmacist NUCC Code: 183500000X (Pharmacist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 346 STATE ROUTE 58 E, CLINTON, KY, 42031-9425 |
| Practice Telephone / Fax | Tel: (270) 236-2588 | Fax: (270) 236-9162 |
| Administrative Mailing Address | 346 STATE ROUTE 58 E, CLINTON, KY, 42031-9425 |
| Enumeration & Last Sync | Enumerated: 2010-11-13 | CMS Record Updated: 2010-11-13 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (183500000X)
What Does Taxonomy Code 183500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MICHAEL SHAWN BOAZ, r.ph)
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 |
|---|---|
183500000X — PharmacistPlain English: Licensed & Credentialed Pharmacist | State: KY | License: 014549 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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