Active NPI
Luke Archer
- Obstetrics & Gynecology Physician
- Springfield, IL
National Provider Identifier
1659953057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 125.082058
- Practice address
- 415 N 9TH
Springfield, IL 62702-1702 - Phone
- (217) 545-8000
- Fax
- (217) 545-7958
- NPI assigned
- Apr 25, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 125.082058 | IL | Primary |
Addresses
Primary practice location
415 N 9TH
Springfield, IL 62702-1702
Mailing address
P.O. Box 19640
Springfield, IL 62794-9640
Phone (217) 545-8000
Other practice location 1
500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230720000147 | IL | Order and Referring Only - Obstetrics/Gynecology | 3375903586 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687651200000",
"number": "1659953057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 19640",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949640",
"telephone_number": "217-545-8000",
"fax_number": "217-545-7958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 N 9TH",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627021702",
"telephone_number": "217-545-8000",
"fax_number": "217-545-7958"
}
],
"practiceLocations": [
{
"address_1": "500 S Preston St Rm 305",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402021702",
"country_code": "US",
"telephone_number": "502-852-8696",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARCHER",
"first_name": "LUKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-25",
"last_updated": "2023-06-25",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "125.082058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.