Jacob Ryan Archer, EMT

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

E120142 Issued in CA

Practice address

1607 E Palmdale Blvd Ste D
Palmdale, CA 93550-4880

Phone

(310) 728-9089

NPI assigned

May 11, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

State licenses

Practice roles

Locations

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.

• Archer Medtrans LLC

  • Non-emergency Medical Transport (VAN)
  • Palmdale, CA
  • NPI 1750056883
  NPD Authorized official

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1285218669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E PALMDALE BLVD STE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504880",
            "telephone_number": "310-728-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E PALMDALE BLVD STE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504880",
            "telephone_number": "310-728-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "EMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E120142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PC",
            "affiliation": "N",
            "endpointDescription": "Main Office Computer",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1607 E Palmdale Blvd Ste D",
            "city": "Palmdale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935504880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Aranda
• Rofel Araula
• Vasuki Aravagiri
• Adrienne Arca
• Archer Medtrans LLC
• Kyrah Archibald Williams
• Oscar Arcia, MD
• Armand Ardestani, DO
• Areliant Care Services
• Salvador A Arella Sr., M.D.

• All providers in Palmdale, CA
• Basic Emergency Medical Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.