Active NPI
Andrea R Archer, N.P.
- Acute Care Nurse Practitioner
- Davenport, IA
National Provider Identifier
1023145208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- L-092677
- Practice address
- 1227 E Rusholme St
Davenport, IA 52803-2459 - Phone
- (563) 421-7198
- Fax
- (563) 421-7159
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | L-092677 | IA | Primary |
Addresses
Primary practice location
1227 E Rusholme St
Davenport, IA 52803-2459
Mailing address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-7198
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0442392 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-092677 | IA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023145208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1227 E RUSHOLME ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528032459",
"telephone_number": "563-421-7198",
"fax_number": "563-421-7159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 E RUSHOLME ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528032459",
"telephone_number": "563-421-7198",
"fax_number": "563-421-7159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "ANDREA",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "IA",
"license": "L-092677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0442392",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.