Individual provider Active NPI

Janice Elena Archer, AP RN CS

  • Psychiatric/Mental Health Nurse Practitioner
  • Warwick, RI
National Provider Identifier
1063417855
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CAPRN00923 Issued in RI
Practice address
60 Merrymount Dr
Warwick, RI 02888-5525
Phone
(401) 463-7521
NPI assigned
Jun 17, 2005
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CAPRN00923 RI Primary

Addresses

Primary practice location

60 Merrymount Dr
Warwick, RI 02888-5525

Mailing address

60 Merrymount Dr
Warwick, RI 02888-5525
Phone (401) 463-7521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622000486 RI Practitioner - Nurse Practitioner 4284925249 Practice locations: Warwick, RI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAPRN00923RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Counsiling Center Janice Archeer Sole MBR Psychiatric/Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1063417855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MERRYMOUNT DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028885525",
            "telephone_number": "401-463-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRYMOUNT DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028885525",
            "telephone_number": "401-463-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JANICE",
        "middle_name": "ELENA",
        "credential": "AP RN  CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "CAPRN00923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.