Kendis Archer, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME125164 Issued in FL

Practice address

4720 Silent Creek LN
Tallahassee, FL 32303-8946

Phone

(772) 801-9885

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Leonidas Vitality Health Clinic

  • Family Medicine Physician
  • Wildwood, FL
  • NPI 1053263582
  NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1104031061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 SILENT CREEK LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323038946",
            "telephone_number": "772-801-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 SILENT CREEK LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323038946",
            "telephone_number": "772-801-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "KENDIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2010040907",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME125164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME125164",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2010040907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarence William Applegate, MD
• Emilee Newsom Applegate, RN
• Denali Applewhite
• Apria Healthcare LLC
• Kayla Charisse April, LCSW, CDP
• Archway LLC
• Erika Ard
• Holly Jean Ardolf
• Area Agency on Aging for North Florida, Inc. (Area Agency on Aging for North Florida d/b/a Advantage Aging Solutions)
• Stephanie Areas

• General Practice Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.