Jennifer R Archibald, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA212879 Issued in OR

Practice address

3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982

Phone

(541) 883-2337

Fax

(541) 883-2504

NPI assigned

Oct 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MT, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370

  OR

  Medicare reassignment NPD
• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845

  MT

  Medicare reassignment
• Northern Montana Hospital

  • Critical Access Hospital
  • Havre, MT
  • NPI 1427059070

  MT

  Medicare reassignment
• Billings Clinic

  • Skilled Nursing Facility
  • Billings, MT
  • NPI 1033275557
  NPD
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714
  NPD
• Northern Montana Hospital

  • Critical Access Hospital
  • Havre, MT
  • NPI 1578536355
  NPD
• Northern Montana Hospital

  • Clinic/Center
  • Havre, MT
  • NPI 1669447967
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1144409103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 W BROAD ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464610",
            "telephone_number": "877-230-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY STE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034982",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1069 W Broad St",
            "address_2": "Suite 908",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220464610",
            "country_code": "US",
            "telephone_number": "877-230-9617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110004222",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "655",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA212879",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C03660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1144409103",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144409103",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1081067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Angell
• Anthony Victor Anghinetti
• Applewood Women'S Center PC
• Cassidy Jean Appolonio
• Rosie Arauz
• Maria Guadalupe Arechiga
• Martin Wayne Argall, DC
• John Michael Arias Sr., MA, NCC, LPC - MHSP
• Paige Marie Armstrong
• Mandeep Arora

• All providers in Klamath Falls, OR
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.