NPIMap

Individual provider Active NPI

Ryan Neal Archie, MD

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1386803286
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N6143 Issued in TX
Practice address
6451 Brentwood Stair Rd
Fort Worth, TX 76112-3200
Phone
(817) 496-9700
NPI assigned
Jun 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N6143 TX Primary

Addresses

Primary practice location

6451 Brentwood Stair Rd
Fort Worth, TX 76112-3200

Mailing address

6451 Brentwood Stair Rd
Fort Worth, TX 76112-3200
Phone (817) 496-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924001859 CO Practitioner - Emergency Medicine 9032393905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professionals of Colorado PCGroup PAC ID 2860706967, 41 clinicians

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 352-4121

Hospital & facility affiliations

  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126
  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N6143TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients

Locations

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 70th Ave
Greeley, CO 80634
Phone (970) 352-7366

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1386803286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-496-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-496-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIE",
        "first_name": "RYAN",
        "middle_name": "NEAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N6143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.