NPIMap

Organization Active NPI

S Archibald OD PC

Doing business as Focus Family Eyecare

  • Optometrist
  • Fargo, ND
National Provider Identifier
1235422007
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
689 Issued in ND
Legal business name
S ARCHIBALD OD PC
Doing business as
Focus Family Eyecare
Practice address
3409 45TH St S Ste 100
Fargo, ND 58104-8970
Phone
(701) 561-0086
Fax
(701) 561-0087
NPI assigned
May 26, 2011
Last updated
Sep 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Authorized official

Name
Dr. Stacey Archibald, O.D.NPI 1306139266
Title
President
Phone
(701) 561-0086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 689 ND Primary

Addresses

Primary practice location

3409 45TH St S Ste 100
Fargo, ND 58104-8970

Mailing address

3409 45TH St S Ste 100
Fargo, ND 58104-8970
Phone (701) 561-0086

Other names 1

  • Focus Family Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150817002520 ND Part B Supplier - Clinic/Group Practice 7618282880 Receives reassigned benefits from 1 practitioner
Practice locations: Fargo, ND

National Provider Directory

National Provider Directory

Locations

3409 45th St S
Ste 100
Fargo, ND 58104
Phone (701) 277-3636

3902 13th Ave S
Ste 5256
Fargo, ND 58103
Phone (701) 277-3636

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1235422007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 45TH ST S STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048970",
            "telephone_number": "701-561-0086",
            "fax_number": "701-561-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 45TH ST S STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048970",
            "telephone_number": "701-561-0086",
            "fax_number": "701-561-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S ARCHIBALD OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-561-0086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Focus Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Focus Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.