Individual provider Active NPI

James S Archer, MD

  • Urology Physician
  • Oklahoma City, OK
National Provider Identifier
1790747293
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
13089 Issued in OK
Practice address
1211 N Shartel Ave
Suite 300
Oklahoma City, OK 73103-2400
Phone
(405) 235-8008
Fax
(405) 239-2403
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 13089 OK Primary

Addresses

Primary practice location

1211 N Shartel Ave
Suite 300
Oklahoma City, OK 73103-2400

Mailing address

1211 S Shartel Ave
Suite 300
Oklahoma City, OK 73170
Phone (405) 235-8008

Other identifiers 1

IdentifierTypeStateIssuer
100106990AMedicaidOK

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070223000183 OK Practitioner - Urology 6507881141 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Surgical Group, PLLC CurrentSince Feb 1, 2017 Accepting new patients
Norman Regional Providers Primary Care Past Accepting new patients
Surgical Specialists of Oklahoma PLLC Past Accepting new patients

Locations

2525 NW Expressway
Ste 610
Oklahoma City, OK 73112
Phone (405) 242-2181

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEAHBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1790747293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S SHARTEL AVE",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73170",
            "telephone_number": "405-235-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N SHARTEL AVE",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032400",
            "telephone_number": "405-235-8008",
            "fax_number": "405-239-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JAMES",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "13089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.