NPIMap

Organization Active NPI

Lurley J. Archambeau MD

  • Psychiatry Physician
  • Maumee, OH
National Provider Identifier
1205077336
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35999 Issued in OH
Legal business name
LURLEY J. ARCHAMBEAU MD
Practice address
6450 Weatherfield CT.
Ste. 1B
Maumee, OH 43537-8919
Phone
(419) 866-2830
Fax
(419) 866-2831
NPI assigned
Mar 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Authorized official

Name
Maureen Marx
Title
Office Manager
Phone
(419) 866-2830

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 35999 OH Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X 35999 OH

Addresses

Primary practice location

6450 Weatherfield CT.
Ste. 1B
Maumee, OH 43537-8919

Mailing address

6450 Weatherfield CT.
Ste. 1B
Maumee, OH 43537-8919
Phone (419) 866-2830

Other identifiers 2

IdentifierTypeStateIssuer
0275330MedicaidOH
128773OtherOHVALUE OPTIONS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1205077336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 WEATHERFIELD CT.",
            "address_2": "STE. 1B",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435378919",
            "telephone_number": "419-866-2830",
            "fax_number": "419-866-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 WEATHERFIELD CT.",
            "address_2": "STE. 1B",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435378919",
            "telephone_number": "419-866-2830",
            "fax_number": "419-866-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LURLEY J. ARCHAMBEAU MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-866-2830"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35999",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "OH",
            "license": "35999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0275330",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "128773",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.