Individual provider Active NPI

Victoria Kay Archibald, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1780105858
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
900 W Magnolia Ave Ste 100
Fort Worth, TX 76104-8518
Phone
(817) 870-7300
Fax
(817) 332-5117
NPI assigned
Jun 29, 2017
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

900 W Magnolia Ave Ste 100
Fort Worth, TX 76104-8518

Mailing address

1250 8TH Ave Ste 650
Fort Worth, TX 76104-4160
Phone (817) 912-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170926002819 TX Practitioner - Physician Assistant 7214201425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1307 8TH Ave
Suite 406
Fort Worth, TX 76104-4141
Phone (817) 912-8040

1400 8TH Ave
Fort Worth, TX 76104-4110

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 25, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 25, 2021 Accepting new patients
Texas Digestive Disease Consultants, PLLC CurrentSince Aug 29, 2017 Accepting new patients
Texas Digestive Disease Consultants PLLC CurrentSince Aug 29, 2017 Accepting new patients
Healthtexas Provider Network PastSince Oct 1, 2023 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

9509 N Beach St
Ste 101
Fort Worth, TX 76244
Phone (817) 741-4347

900 W Magnolia Ave
Ste 100
Ft Worth, TX 76104
Phone (817) 870-7300

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

Interoperability endpoints

  • Direct secure messaging: varchibald773062@direct.sw.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1780105858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE STE 650",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044160",
            "telephone_number": "817-912-9180",
            "fax_number": "817-912-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAGNOLIA AVE STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761048518",
            "telephone_number": "817-870-7300",
            "fax_number": "817-332-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "VICTORIA",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.