Organization Active NPI

Archdale Optometry Corporation PLLC

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1275660565
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1466 Issued in CO
Legal business name
ARCHDALE OPTOMETRY CORPORATION PLLC
Practice address
7095 Lexington Dr
Colorado Springs, CO 80918-6329
Phone
(719) 638-4010
Fax
(719) 638-4021
NPI assigned
Feb 27, 2007
Last updated
Dec 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
Theodore (Ted) Archdale, OD
Title
Owner
Phone
(719) 638-4010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1466 CO Primary

Addresses

Primary practice location

7095 Lexington Dr
Colorado Springs, CO 80918-6329

Mailing address

7095 Lexington Dr
Colorado Springs, CO 80918-6329
Phone (719) 638-4010

Other identifiers 3

IdentifierTypeStateIssuer
08014664MedicaidCO
1588660161OtherCOPERSONAL NPI
26777312MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000267 CO Part B Supplier - Clinic/Group Practice 0345216461 Receives reassigned benefits from 6 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

3204 N Academy Blvd
Ste 120
Colorado Spgs, CO 80917
Phone (719) 638-4010

7095 Lexington Dr
Colorado Springs, CO 80918
Phone (719) 638-4010

Practitioners & affiliated clinicians

Practitioners 11

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1275660565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7095 LEXINGTON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186329",
            "telephone_number": "719-638-4010",
            "fax_number": "719-638-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7095 LEXINGTON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186329",
            "telephone_number": "719-638-4010",
            "fax_number": "719-638-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHDALE OPTOMETRY CORPORATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "ARCHDALE",
        "authorized_official_first_name": "THEODORE (TED)",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-638-4010",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08014664",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1588660161",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26777312",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.