Kimberly Nicole Archer – Behavior Technician

Key facts

NPI: 1699533745
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 321 SE 3Rd St
Toledo, OR 97391-1613
Phone: (541) 336-2254
NPI assigned: Mar 12, 2024
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

321 SE 3Rd St
Toledo, OR 97391-1613

Mailing address

321 SE 3Rd St
Toledo, OR 97391-1613
Phone (541) 336-2254

Other names

Kimberly Nicole Camerer Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 12, 2024.

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1699533745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 SE 3RD ST",
            "city": "TOLEDO",
            "state": "OR",
            "postal_code": "973911613",
            "telephone_number": "541-336-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 SE 3RD ST",
            "city": "TOLEDO",
            "state": "OR",
            "postal_code": "973911613",
            "telephone_number": "541-336-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CAMERER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OR

All providers in Toledo, OR · Behavior Technician in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.