CMS-1500 Box 24J / 33a • NPI
1881660280
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
364S00000X (CMS 89)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist
Box 32 Service Location & ZIP+4
1055 CLERMONT ST, CARDILOGY 111-B, DENVER, CO, 80220-3808
✓ 9-Digit EDI 837 ZIP+4 (80220-3808)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1881660280 (KATHY JOHANNA LIBERATORE, RN, MN, CNS) 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 | 1881660280 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KATHY JOHANNA LIBERATORE, RN, MN, CNS |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist NUCC Code: 364S00000X (Clinical Nurse Specialist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1055 CLERMONT ST, CARDILOGY 111-B, DENVER, CO, 80220-3808 |
| Practice Telephone / Fax | Tel: (303) 399-8020 | Fax: (303) 393-5054 |
| Administrative Mailing Address | 800 RALSTON CREEK LN, BLACK HAWK, CO, 80422-8842 |
| Enumeration & Last Sync | Enumerated: 2006-02-24 | CMS Record Updated: 2010-01-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (364S00000X)
What Does Taxonomy Code 364S00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364S00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KATHY JOHANNA LIBERATORE, RN, MN, CNS)
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 |
|---|---|
364S00000X — Clinical Nurse SpecialistPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist | State: CO | License: 51776 | Primary: Secondary |
364S00000X — Clinical Nurse SpecialistPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist | State: CO | License: 0672 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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