CMS-1500 Box 24J / 33a • NPI
1972059160
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
364SF0001X (CMS 89)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Family Health
Box 32 Service Location & ZIP+4
5209 7 PINES DR, LORAIN, OH, 44053-3315
✓ 9-Digit EDI 837 ZIP+4 (44053-3315)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1972059160 (ADVANCED PRACTICE PRIMARY CARE AT HOME) 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 | 1972059160 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED PRACTICE PRIMARY CARE AT HOME |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Family Health NUCC Code: 364SF0001X (Clinical Nurse Specialist, Family Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 5209 7 PINES DR, LORAIN, OH, 44053-3315 |
| Practice Telephone / Fax | Tel: (440) 260-6100 | Fax: (440) 220-5105 |
| Administrative Mailing Address | 5209 SEVEN PINES DR, LORAIN, OH, 44053-3315 |
| Enumeration & Last Sync | Enumerated: 2016-08-29 | CMS Record Updated: 2025-10-29 |
| Authorized Official | EVANGELINE GARCIA (owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (364SF0001X)
What Does Taxonomy Code 364SF0001X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SF0001X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Family Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED PRACTICE PRIMARY CARE AT HOME)
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 |
|---|---|
364SF0001X — Clinical Nurse Specialist, Family HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Family Health | State: OH | License: COA.15775-NP | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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