Individual provider Active NPI

Graeme C.M. Archer, MD

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1326240797
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-6060 Issued in AR
Practice address
1000 SE 13TH CT
Bentonville, AR 72712-7857
Phone
(479) 273-9056
Fax
(479) 273-6937
NPI assigned
Jun 5, 2007
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-6060 AR Primary

Addresses

Primary practice location

1000 SE 13TH CT
Bentonville, AR 72712-7857

Mailing address

1000 SE 13TH CT
Bentonville, AR 72712-7857
Phone (479) 273-9056

Other identifiers 1

IdentifierTypeStateIssuer
179420001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000646 AR Practitioner - Emergency Medicine 4486791381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arkansas College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 SE 13TH CT
Bentonville, AR 72712-7857
Phone (479) 273-9056

2708 S Rife Medical LN
Suite T30
Rogers, AR 72758-1458
Phone (479) 338-3999

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

4100 SW I St
Bentonville, AR 72713-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-6060ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities Family Medicine CurrentSince Jul 11, 2011 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jul 11, 2011 Accepting new patients

Locations

1000 SE 13th Ct
Bentonville, AR 72712
Phone (479) 273-9056

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 636-0200

Interoperability endpoints

  • Direct secure messaging: garcher208240@directc.mercy.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1326240797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SE 13TH CT",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127857",
            "telephone_number": "479-273-9056",
            "fax_number": "479-273-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SE 13TH CT",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127857",
            "telephone_number": "479-273-9056",
            "fax_number": "479-273-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "GRAEME",
        "middle_name": "C.M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-6060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179420001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.