JEAN A ANSCOMBE, RNCS — NPI 1790833184 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric

CMS-1500 Box 24J / 33a • NPI

1790833184

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

364SP0808X (CMS 89)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health

Box 32 Service Location & ZIP+4

85 EASTERN AVE STE 302, GLOUCESTER, MA, 01930-1869

✓ 9-Digit EDI 837 ZIP+4 (01930-1869)

Practice Phone & Referral Fax

(978) 559-0001

Fax: (978) 559-0003

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790833184 (JEAN A ANSCOMBE, RNCS) 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	`1790833184` (NPI-1 Individual Practitioner)
Provider / Legal Name	JEAN A ANSCOMBE, RNCS
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health NUCC Code: `364SP0808X` (Clinical Nurse Specialist, Psych/Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	85 EASTERN AVE STE 302, GLOUCESTER, MA, 01930-1869
Practice Telephone / Fax	Tel: (978) 559-0001 \| Fax: (978) 559-0003
Administrative Mailing Address	31 EASTERN POINT RD, GLOUCESTER, MA, 01930-4134
Enumeration & Last Sync	Enumerated: 2007-01-08 \| CMS Record Updated: 2007-07-09

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

85 EASTERN AVE STE 302, GLOUCESTER, MA, 01930-1869

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Plain-English Taxonomy & CMS Crosswalk (364SP0808X)

What Does Taxonomy Code 364SP0808X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 89 (Certified Clinical Nurse Specialist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Nurse Specialist, Psych/Mental Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JEAN A ANSCOMBE, RNCS)

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
`364SP0808X` — Clinical Nurse Specialist, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health	State: MA \| License: `111418` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JEAN A ANSCOMBE, RNCS (NPI #1790833184)