Individual provider Active NPI

Jessica Renee Archer, FNP

  • Family Nurse Practitioner
  • Benton, AR
National Provider Identifier
1346972437
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
220719 Issued in AR
Practice address
824 Military Rd
Benton, AR 72015-3347
Phone
(501) 574-3019
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 220719 AR Primary

Addresses

Primary practice location

824 Military Rd
Benton, AR 72015-3347

Mailing address

8400 Crossroads
Benton, AR 72015-7176
Phone (501) 249-2549

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726003872 AR Practitioner - Nurse Practitioner 9234511064 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archer-Knight Health and Wellness PLLC 2 clinicians

Practice addresses (Care Compare)

112 W Sevier St
Benton, AR 72015-3773
Phone (501) 443-3224

Hospital & facility affiliations

  • Elite Home Health Home health agency, Hot Springs, AR, CCN 047151
  • Saline Memorial Hospital Hospital, Benton, AR, CCN 040084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
220719ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Team of Arkansas Physicians, LLC CurrentSince Jul 3, 2022 Accepting new patients
Icp Arkansas Aco Billing LLC CurrentSince Jul 14, 2022 Accepting new patients
Archer-Knight Health & Wellness PLLC CurrentSince Jan 1, 2025 Accepting new patients
SHC Medical Partners of Arkansas, LLC CurrentSince Jul 15, 2024 Accepting new patients
Integrated Care Professionals, LLC CurrentSince Jul 14, 2022 Accepting new patients
Urgent Team of Arkansas Physicians, LLC PastSince Jul 3, 2022 Accepting new patients

Locations

824 Military Rd
Benton, AR 72015
Phone (501) 574-3019

112 W Sevier St
Benton, AR 72015
Phone (501) 443-3224

200 River Market Ave
Ste 100
Little Rock, AR 72201
Phone (501) 267-9870

200 River Market Ave
Ste 500
Little Rock, AR 72201
Phone (501) 492-0099

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1346972437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 CROSSROADS",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720157176",
            "telephone_number": "501-249-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153347",
            "telephone_number": "501-574-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "220719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.