NPIMap

Organization Active NPI

John T Archer & Associates Inc

Doing business as Premier Vision Group

  • Optometrist
  • Northwood, OH
National Provider Identifier
1821679705
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOHN T ARCHER & ASSOCIATES INC
Doing business as
Premier Vision Group
Practice address
2540 Woodville Rd
Northwood, OH 43619-1444
Phone
(419) 693-0484
Fax
(419) 693-2042
NPI assigned
Apr 21, 2021
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Dr. Cheryl Archer, ODNPI 1447353917
Title
Owner
Phone
(419) 228-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

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 1

  • Premier Vision Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4620 Woodville Rd
Northwood, OH 43619
Phone (419) 693-0484

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1821679705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 WOODVILLE RD",
            "city": "NORTHWOOD",
            "state": "OH",
            "postal_code": "436191444",
            "telephone_number": "419-693-0484",
            "fax_number": "419-693-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WOODVILLE RD",
            "city": "NORTHWOOD",
            "state": "OH",
            "postal_code": "436191444",
            "telephone_number": "419-693-0484",
            "fax_number": "419-693-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN T ARCHER & ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "ARCHER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-228-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Vision Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Vision Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.