Active NPI
Emily Anne Archer, APRN
- Pediatric Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APRN11020671
- Practice address
- 858 Monument Rd Ste B
Jacksonville, FL 32225-6670 - Phone
- (904) 450-8090
- NPI assigned
- Jul 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11020671 | FL | |
| Pediatric Nurse Practitioner | 363LP0200X | APRN11020671 | FL | Primary |
Addresses
Primary practice location
858 Monument Rd Ste B
Jacksonville, FL 32225-6670
Mailing address
4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-8090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11020671 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincents Ambulatory Care Inc | Single Specialty | Current | Accepting new patients |
| St Vincents Ambulatory Care Inc | Current | Accepting new patients | |
| Pediatric Associates at Argyle PA | Single Specialty | Past | Accepting new patients |
| Pediatric Associates at Argyle PA | Single Specialty | Past | Accepting new patients |
Locations
858 Monument Rd
Ste B
Jacksonville, FL 32225
Phone (904) 450-8060
10058 Baymeadows Rd
Jacksonville, FL 32256
Phone (904) 450-6870
4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691
3200 3rd St S
Jacksonville Beach, FL 32250
Phone (904) 450-7050
3200 3rd St S
Ste 101
Jax Bch, FL 32250
Phone (904) 247-4070
Interoperability endpoints
- emily.archer.1@8967.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Neurological Surgery Physician
- Jacksonville, FL
- NPI 1417987124
Single Specialty
-
- Durable Medical Equipment & Medical Supplies
- Jacksonville, FL
- NPI 1679226690
-
- Pediatrics Physician
- Jacksonville, FL
- NPI 1063557460
Single Specialty
-
- Pediatrics Physician
- Jacksonville, FL
- NPI 1144495466
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1346973088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 BELFORT RD STE 4015",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322163623",
"telephone_number": "904-450-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "858 MONUMENT RD STE B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322256670",
"telephone_number": "904-450-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "EMILY",
"middle_name": "ANNE",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-08",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11020671",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "APRN11020671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.