Deshaunta Lynna Archer, RN, BSN

Key facts

NPI

1255691069

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

020503 (OH)

Practice address

2705 Sherbrooke Rd
Toledo, OH 43606-3744

Phone

(419) 508-8321

NPI assigned

May 25, 2012

Sex

Female

Sole proprietor

Yes

Organizations & group practices 4

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.

• Promedica Central Physicians Family Medicine Physician · Toledo, OH · NPI 1043270150
  Medicare reassignment Care Compare group NPD OH
• Promedica Central Physicians Durable Medical Equipment & Medical Supplies · Toledo, OH · NPI 1669068482
  Care Compare group NPD
• Promedica Central Physicians Optometrist · Sylvania, OH · NPI 1871912410
  Care Compare group
• Promedica Central Physicians Durable Medical Equipment & Medical Supplies · Sylvania, OH · NPI 1932595428
  Care Compare group

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Toledo Hospital General Acute Care Hospital · Toledo, OH · NPI 1407854771
  Care Compare affiliation Hospital
• Toledo Hospital Ambulance · Toledo, OH · NPI 1427147339
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central Physicians (785 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital · Toledo, OH · CCN 360068

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Bachelor on Science - Nursing, Certified Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: darcher97154@direct.promedica.org

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 3, 2023.

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1255691069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 SHERBROOKE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063744",
            "telephone_number": "419-508-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 SHERBROOKE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063744",
            "telephone_number": "419-508-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "DESHAUNTA",
        "middle_name": "LYNNA",
        "name_prefix": "Ms.",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN. 339774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "020503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "darcher97154@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Toledo, OH · Family Nurse Practitioner in Ohio