CMS-1500 Box 24J / 33a • NPI
1972281715
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP2300X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care
Box 32 Service Location & ZIP+4
1550 HIGHWAY 15 S STE 240, JACKSON, KY, 41339-0709
✓ 9-Digit EDI 837 ZIP+4 (41339-0709)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1972281715 (JERRY LEE CAMPBELL, aprn) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1972281715)
Medicare Beneficiaries
14
Total Billed Services
35
Distinct CPT/HCPCS Codes
9
Medicare Allowed Total
$680.08
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 24 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 18 | <11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 24 | 22 |
| Atorvastatin Calcium Atorvastatin Calcium | 32 | <11 |
| Azithromycin Azithromycin | 48 | 39 |
| Breztri Aerosphere Budesonide/Glycopyr/Formoterol | 19 | <11 |
| Buprenorphine-Naloxone Buprenorphine Hcl/Naloxone Hcl | 105 | 32 |
| Carbidopa-Levodopa Er Carbidopa/Levodopa | 11 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1972281715 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JERRY LEE CAMPBELL, aprn |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care NUCC Code: 363LP2300X (Nurse Practitioner, Primary Care) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1550 HIGHWAY 15 S STE 240, JACKSON, KY, 41339-0709 |
| Practice Telephone / Fax | Tel: (606) 272-7533 | Fax: (606) 824-5042 |
| Administrative Mailing Address | 1550 HIGHWAY 15 S STE 240, JACKSON, KY, 41339-0709 |
| Enumeration & Last Sync | Enumerated: 2023-07-11 | CMS Record Updated: 2023-07-11 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP2300X)
What Does Taxonomy Code 363LP2300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP2300X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JERRY LEE CAMPBELL, aprn)
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 |
|---|---|
363LP2300X — Nurse Practitioner, Primary CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care | State: KY | License: 4007079 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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