JENNIFER R ARCHIBALD (NPI# 1144409103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144409103 |
| Entity Type | Individual |
| Full Name | JENNIFER R ARCHIBALD |
| Credential | PA-C |
| Practice Address |
1069 W Broad St Suite 908 Falls Church VA 22046-4610 |
| Mailing Address |
1069 W Broad St Falls Church VA 22046-4610 |
| Practice Telephone | 8772309617 |
| Mailing Telephone | 8772309617 |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2013-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
655 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C03660 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0110004222 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BCBS | 1144409103 | 01 |
| NCCPA | 1081067 | 01 | |
| MT | 1144409103 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801373105 | Jennifer Joanna Archibald | Dentist | 300 Longwood Ave, Boston, MA 02115-5724 | 2018-07-19 |
| 1750871703 | Jennifer Kaserman Archibald | Nurse Practitioner | 33 Mollison Way, Lewiston, ME 04240-5805 | 2018-05-15 |
| Street Address |
1069 W BROAD ST SUITE 908 |
| City | FALLS CHURCH |
| State | VA |
| Zip Code | 22046-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710329016 | Claudine Patricia Humphrey | Registered Nurse | 1069 W Broad St, Suite 908, Falls Church, VA 22046-4610 | 2013-07-27 |
| 1770828204 | Heidi Michelle Rosa | Registered Nurse | 1069 W Broad St, Suite 908, Falls Church, VA 22046-4610 | 2012-12-10 |
| 1528329109 | Mukesh Chandubhai Patel | Specialist/Technologist, Other | 1069 W Broad St, Suite 908, Falls Church, VA 22046-4610 | 2012-05-31 |
| 1417218157 | Charles M Graham Jr. | Specialist/Technologist, Other | 1069 W Broad St, Suite 908, Falls Church, VA 22046-4610 | 2012-05-30 |
| 1932468410 | Keith Maas | Specialist/Technologist, Other | 1069 W Broad St, Suite 908, Falls Church, VA 22046-4610 | 2012-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831735794 | Megan Katherine Hassan | Speech-Language Pathologist | 803 West Broad Street, Suite 100, Falls Church, VA 22046 | 2019-11-25 |
| 1205481173 | Michael William Wirtz | Physical Therapist | 510 South Washington Street, Ste. A, Falls Church, VA 22046 | 2019-08-07 |
| 1629636568 | Meaghan A Souza | Physical Therapist | 510 S Washington Street, Suite A, Falls Church, VA 22046 | 2019-06-05 |
| 1619478963 | Teresa Rosas | Dentist | Blvd Fundadores #8417-21, Tijuana, BAJA CALIFORNIA 22046 | 2018-02-22 |
| 1174022974 | Bio Medical Center | Radiology | 3170 General Ferreira, Colonia Madero Sur, Tijuana, BAJA CALIFORNIA 22046 | 2018-02-07 |
| 1558875385 | M & R Taxi Company, Inc. | Non-emergency Medical Transport (VAN) | 1115 West Broad St., Falls Church, VA 22046 | 2017-12-01 |
| 1356860829 | Neurology | Neuromusculoskeletal Medicine & OMM | 701 W Broad St Ste 214, Falls Church, VA 22046 | 2017-09-15 |
| 1184140501 | Christopher Grivas | Chiropractor | 510 W Annandale Road, Suite 300, Falls Church, VA 22046 | 2017-08-17 |
| 1831562719 | Strategy Anesthesia Virginia, LLC | Anesthesiology | 502 W Broad Street (route 7), Falls Church, VA 22046 | 2015-11-02 |
| 1851762025 | Edward A Stern | Registered Nurse | 201 N Washington Street, C/o Kaiser Permanente, Falls Church, VA 22046 | 2015-10-14 |
| Find all providers in zip 22046 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104381060 | Pegah Izadpanah | Physician Assistant | 2755 Hartland Rd Ste 300, Falls Church, VA 22043-3545 | 2019-02-05 |
| 1659889228 | Kirby Holland | Physician Assistant | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2018-01-17 |
| 1023472396 | Carrie I Thomas | Physician Assistant | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2016-04-12 |
| 1881034213 | Bernarda Gallagher | Physician Assistant | 8116 Arlington Blvd, Ste #117, Falls Church, VA 22042-1002 | 2013-06-29 |
| 1851640171 | Brian Onuscheck | Physician Assistant | 8116 Arlington Blvd, Ste #117, Falls Church, VA 22042-1002 | 2012-08-31 |
| 1992080048 | Nathaniel Brian Schaefer | Physician Assistant | 2922 Telestar Ct, Falls Church, VA 22042-1206 | 2011-10-19 |
| 1164723524 | Daniel Fernando Naranjo | Physician Assistant | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2010-11-16 |
| 1114250842 | Erick Black | Physician Assistant | 8116 Arlington Blvd Ste 117, Falls Church, VA 22042-1002 | 2009-09-14 |
| 1053541607 | Iyla Tikhonov | Physician Assistant | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2009-07-16 |
| 1396986923 | Charles Robinson | Physician Assistant | 8116 Arlington Blvd Ste 122, Falls Church, VA 22042-1002 | 2009-03-11 |
| Find all providers in FALLS CHURCH | ||||
| City | FALLS CHURCH |
| Zip Code | 22046 |
Please comment or provide details below to improve the information on JENNIFER R ARCHIBALD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.