Individual provider Active NPI

Scott Donald Archer, COTA

  • Occupational Therapy Assistant
  • Chagrin Falls, OH
National Provider Identifier
1306583414
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA006361 Issued in OH
Practice address
5277 Chillicothe Rd
Chagrin Falls, OH 44022-4334
Phone
(440) 557-1186
NPI assigned
May 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA006361 OH Primary

Addresses

Primary practice location

5277 Chillicothe Rd
Chagrin Falls, OH 44022-4334

Mailing address

511 Independence St
Fairport Harbor, OH 44077-5641
Phone (440) 289-3463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA006361OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1306583414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 INDEPENDENCE ST",
            "city": "FAIRPORT HARBOR",
            "state": "OH",
            "postal_code": "440775641",
            "telephone_number": "440-289-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5277 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224334",
            "telephone_number": "440-557-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "SCOTT",
        "middle_name": "DONALD",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA006361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.