Tyler Russell Archer, MSN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23287 Issued in TN

Practice address

102 Dunhill PL NW
Cleveland, TN 37311

Phone

(423) 339-9581

Fax

(423) 472-0494

NPI assigned

Oct 11, 2017

Last updated

May 28, 2020By 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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interventional Pain ConsultantsGroup PAC ID 7416323514, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Knoxville, TN, CCN 447142
• Adoration Home Health and Hospice Care East TN Home health agency, Cleveland, TN, CCN 447279
• Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Interventional Pain Consultants

  • Interventional Pain Medicine Physician
  • Cleveland, TN
  • NPI 1174241145
  Medicare reassignment Care Compare group NPD
• Elite Pain Consultants, PLLC

  • Pain Medicine Physician
  • Cleveland, TN
  • NPI 1497267173
  Medicare reassignment NPD
• Interventional Pain Consultants

  • Durable Medical Equipment & Medical Supplies
  • Ringgold, GA
  • NPI 1629932389
  NPD
• Mahmood a Siddiqui MD PC

  • Internal Medicine Physician
  • Copperhill, TN
  • NPI 1427070523
  NPD (past)

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

• Athens Regional Medical Center LLC

  dba Starr Regional Medical Center

  • General Acute Care Hospital
  • Athens, TN
  • NPI 1669567319
  Care Compare affiliation
• Camellia Home Health of East Tennessee, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Knoxville, TN
  • NPI 1346569811
  Care Compare affiliation
• Home Health Care of East Tennessee, Inc.

  dba Adoration Home Health and Hospice Care East Tennessee

  • Home Health Agency
  • Cleveland, TN
  • NPI 1285617605
  Care Compare affiliation

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1548770944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113885",
            "telephone_number": "423-476-5774",
            "fax_number": "423-472-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37311",
            "telephone_number": "423-339-9581",
            "fax_number": "423-472-0494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4021 Keith St NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373124341",
            "country_code": "US",
            "telephone_number": "423-328-1006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4021 Keith St NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "37312",
            "country_code": "US",
            "telephone_number": "423-328-1006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "TYLER",
        "middle_name": "RUSSELL",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-11",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aptitude Behavioral Services, LLC
• Clemente Ocampo Aquino Jr., OTR/L
• Emmanuel Aragon
• Rebekah Aranda, OT
• Roxana Edith Araujo, NP
• Aria Behavior Analysis, LLC
• Arlington Caregiving
• Lynette Amber Armstrong
• Amanda Arnold, SLP
• Melissa Arrendale, SLP-CCC

• Family Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.