John T Archer & Associates Inc
Organization Active NPI Optometrist · Northwood, OH
NPI 1821679705 · NPPES record last updated Apr 27, 2021
Key facts
- NPI
- 1821679705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- JOHN T ARCHER & ASSOCIATES INC
- Practice address
- 2540 Woodville Rd
Northwood, OH 43619-1444 - Phone
- (419) 693-0484
- Fax
- (419) 693-2042
- NPI assigned
- Apr 21, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Cheryl Archer, OD
- Title
- Owner
- Phone
- (419) 228-3937
Other NPIs on the same Medicare enrollment 4
Practitioners 5
-
Cheryl Archer, OD
-
Mile Brujic, O.D.
-
Tracey G Needham, O.D.
-
John T Archer, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040412000810 | OH | Part B Supplier - Clinic/Group Practice | 9931193158 |
Receives reassigned benefits from 5 practitioners 4 other NPIs on this enrollment Practice locations: Bowling Green, OH; Northwood, OH |
National Provider Directory
Locations
4620 Woodville Rd
Northwood, OH 43619
Phone (419) 693-0484
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
2540 Woodville Rd
Northwood, OH 43619-1444
Mailing address
2540 Woodville Rd
Northwood, OH 43619-1444
Phone (419) 693-0484
Other names
- Premier Vision Group
Other providers in Northwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.