CMS-1500 Box 24J / 33a • NPI
1962805812
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
229N00000X (CMS 56)
Licensed & Credentialed Respiratory, Developmental, Rehabilitative, and Restorative Service Providers — Anaplastologist
Box 32 Service Location & ZIP+4
6 W GE PATTERSON AVE, SUITE 102, MEMPHIS, TN, 38103-6413
✓ 9-Digit EDI 837 ZIP+4 (38103-6413)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1962805812 (ALLOPLASTIC RECONSTRUCTION) 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 | 1962805812 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ALLOPLASTIC RECONSTRUCTION |
| Plain-English Specialty | Licensed & Credentialed Respiratory, Developmental, Rehabilitative, and Restorative Service Providers — Anaplastologist NUCC Code: 229N00000X (Anaplastologist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 6 W GE PATTERSON AVE, SUITE 102, MEMPHIS, TN, 38103-6413 |
| Practice Telephone / Fax | Tel: (901) 410-5375 | Fax: (800) 977-4149 |
| Administrative Mailing Address | 220 N. VAN BUREN, LITTLE ROCK, AR, 72205 |
| Enumeration & Last Sync | Enumerated: 2014-10-07 | CMS Record Updated: 2015-01-09 |
| Authorized Official | MICHAEL KACZKOWSKI (PRESIDENT) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (229N00000X)
What Does Taxonomy Code 229N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 229N00000X translates to:
"Licensed & Credentialed Respiratory, Developmental, Rehabilitative, and Restorative Service Providers — Anaplastologist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALLOPLASTIC RECONSTRUCTION)
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 |
|---|---|
156FX1700X — Technician/Technologist, OcularistPlain English: Licensed & Credentialed Eye and Vision Services Providers, Technician — Technologist, Ocularist | State: N/A | License: Verified | Primary: Secondary |
335E00000X — Prosthetic/Orthotic SupplierPlain English: Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier | State: AR | License: OPP00038 | Primary: Secondary |
229N00000X — AnaplastologistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative, and Restorative Service Providers — Anaplastologist | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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