Individual provider Active NPI

Devorah Archer-Webb, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1063468650
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1107 Issued in OK
Practice address
8106 N May Ave Ste J
Oklahoma City, OK 73120-4524
Phone
(405) 632-4616
NPI assigned
May 25, 2006
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1107 OK
Physician Assistant 363A00000X 1107 OK Primary

Addresses

Primary practice location

8106 N May Ave Ste J
Oklahoma City, OK 73120-4524

Mailing address

8106 N May Ave Ste J
Oklahoma City, OK 73120-4524
Phone (405) 632-4616

Other practice location 1

6501 S Western Ave
Oklahoma City, OK 73139-1709
Phone (405) 632-4616

Other practice location 2

3705 NW 63rd St Ste 201
Oklahoma City, OK 73116-1937
Phone (405) 252-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040309000552 OK Practitioner - Physician Assistant 3375431547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Orthopedic and Trauma Institute LLCGroup PAC ID 5092123109, 2 clinicians

Practice addresses (Care Compare)

2230 N Perkins Rd
Stillwater, OK 74075-3076
Phone (405) 780-9919

3130 SW 89TH St
Suite 200
Oklahoma City, OK 73159-7909
Phone (405) 252-7484

3705 NW 63Rd St
Suite 201
Oklahoma City, OK 73116-1937
Phone (405) 252-7484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1107OKMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Trauma Institute LLC CurrentSince Feb 19, 2025 Accepting new patients
C L Soo MD PC Past Accepting new patients

Locations

3130 SW 89th St
Ste 200
Oklahoma City, OK 73159
Phone (405) 645-5475

3705 NW 63rd St
Ste 201
Oklahoma City, OK 73116
Phone (405) 673-3280

Organizations & group practices 4

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1063468650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106 N MAY AVE STE J",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204524",
            "telephone_number": "405-632-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8106 N MAY AVE STE J",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204524",
            "telephone_number": "405-632-4616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731391709",
            "country_code": "US",
            "telephone_number": "405-632-4616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3705 NW 63rd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731161937",
            "country_code": "US",
            "telephone_number": "405-252-7490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHER-WEBB",
        "first_name": "DEVORAH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1107",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.