Roger W Archer, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1071 Issued in TN

Practice address

101 Professional Park PVT Dr
Kingsport, TN 37663-2288

Phone

(423) 224-3350

Fax

(423) 239-8581

NPI assigned

Aug 11, 2006

Last updated

Mar 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• State of Franklin Healthcare Associates PLLC

  • Clinical Medical Laboratory
  • Johnson City, TN
  • NPI 1841846136
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1508877846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3889",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023889",
            "telephone_number": "423-230-2100",
            "fax_number": "423-230-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK PVT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632288",
            "telephone_number": "423-224-3350",
            "fax_number": "423-239-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5612721",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Appalachian Rehabilitation Professionals, PC
• Holly C Appleberry, DO, MBA
• Kirsten Danella Applegate Walton
• Apria Healthcare LLC
• Heather Dyan Archer, PHARMD
• Ruhma Arif, M.D.
• Sarah Arif, M.D.
• Laura Arnfield, LCSW
• Julie Danielle Arnold, COTA
• David J Arrowood, CRNA

• Family Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.

Verify at the official NPI Registry.