Individual provider Active NPI

Beverly Lorraine- Archer Lindsay, M.D.

  • General Practice Physician
  • Fort Meade, MD
National Provider Identifier
1326129446
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D0040788 Issued in MD
Practice address
2480 Llewellyn Ave
Fort Meade, MD 20755-7081
Phone
(301) 677-8800
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X D0040788 MD Primary

Addresses

Primary practice location

2480 Llewellyn Ave
Fort Meade, MD 20755-7081

Mailing address

12305 Chagall Drive
North Potomac, MD 20878
Phone (301) 590-8152

Other names 1

  • Beverly Lorraine Archer Former name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0040788MDMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1326129446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12305 CHAGALL DRIVE",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "301-590-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "BEVERLY",
        "middle_name": "LORRAINE- ARCHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0040788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "ARCHER",
            "middle_name": "LORRAINE",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.