CMS-1500 Box 24J / 33a • NPI
1992429930
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
261QR0400X (CMS B4[14])
Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center
Box 32 Service Location & ZIP+4
12 DOGWOOD WAY, TROY, VA, 22974-6231
✓ 9-Digit EDI 837 ZIP+4 (22974-6231)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1992429930 (PEDIATRIC OASIS) 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 | 1992429930 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | PEDIATRIC OASIS |
| Plain-English Specialty | Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: 261QR0400X (Clinic/Center, Rehabilitation) |
| Certifying / Licensing Body | Accreditation Association for Ambulatory Health Care (AAAHC) / CMS |
| Practice Location Address | 12 DOGWOOD WAY, TROY, VA, 22974-6231 |
| Practice Telephone / Fax | Tel: (304) 719-5598 |
| Administrative Mailing Address | 12 DOGWOOD WAY, TROY, VA, 22974-6231 |
| Enumeration & Last Sync | Enumerated: 2022-10-03 | CMS Record Updated: 2022-10-03 |
| Authorized Official | SHERAIN BRUCE (Owner/CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (261QR0400X)
What Does Taxonomy Code 261QR0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QR0400X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (PEDIATRIC OASIS)
Typical CPT / Diagnostic Procedures:- Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
- Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures
- Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
224Z00000X — Occupational Therapy AssistantPlain English: Licensed & Credentialed Occupational Therapy Assistant | State: N/A | License: Verified | Primary: Secondary |
2251P0200X — Physical Therapist, PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Secondary |
225200000X — Physical Therapy AssistantPlain English: Licensed & Credentialed Physical Therapy Assistant | State: N/A | License: Verified | Primary: Secondary |
225XM0800X — Occupational Therapist, Mental HealthPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
225XP0019X — Occupational Therapist, Physical RehabilitationPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
225XP0200X — Occupational Therapist, PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Secondary |
235Z00000X — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers | State: N/A | License: Verified | Primary: Secondary |
261QR0400X — Clinic/Center, RehabilitationPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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