Active NPI
Brandon Archer, PTA
- Physical Therapy Assistant
- Burlington, NC
National Provider Identifier
1184189367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 6817
- Practice address
- 3801 Wade Coble Dr
Burlington, NC 27215-9765 - Phone
- (336) 538-1522
- NPI assigned
- Feb 1, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6817 | NC | Primary |
Addresses
Primary practice location
3801 Wade Coble Dr
Burlington, NC 27215-9765
Mailing address
5618 Weslo Willow Cir Apt 312
Greensboro, NC 27409-1741
Phone (336) 688-7140
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6817 | NC | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1184189367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5618 WESLO WILLOW CIR APT 312",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274091741",
"telephone_number": "336-688-7140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 WADE COBLE DR",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159765",
"telephone_number": "336-538-1522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "BRANDON",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "6817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.