Shane A Archibald, RN, DNP, APRN, FNP-C in Bountiful, UT

Shane A Archibald, RN, DNP, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Bountiful, Utah. His current practice location is 185 S 400 E Ste 100, Bountiful, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 397-6200.

Shane A Archibald is licensed to practice in Utah (license number 7672413-4405) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861155228.

Contact Information

	Shane A Archibald, RN, DNP, APRN, FNP-C
	185 S 400 E Ste 100, Bountiful, UT 84010-4862
	(801) 397-6200
	(801) 397-6201

Map and Direction

Provider's Profile

Full Name	Shane A Archibald
Gender	Male
Speciality	Nurse Practitioner - Family
Location	185 S 400 E Ste 100, Bountiful, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861155228
Provider Enumeration Date: 10/21/2021
Last Update Date: 11/11/2022

Medicare PECOS Information:

PECOS PAC ID: 5991171647
Enrollment ID: I20221020001038

Medical Identifiers

Medical identifiers for Shane A Archibald such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861155228	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	7672413-4405 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shane A Archibald allows following entities to bill medicare on his behalf.

Entity Name	Ogden Clinic Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578550083 PECOS PAC ID: 9638078033 Enrollment ID: O20040105000780

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shane A Archibald is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shane A Archibald, RN, DNP, APRN, FNP-C Po Box 5546, Denver, CO 80217-5546 Ph: (801) 475-3500	Shane A Archibald, RN, DNP, APRN, FNP-C 185 S 400 E Ste 100, Bountiful, UT 84010-4862 Ph: (801) 397-6200

Reviews and Comments

Nurse Practitioner Nurses in Bountiful, UT

Andrew Garver, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 415 Medical Dr Ste A100, Bountiful, UT 84010 Phone: 801-683-1062
Kenzlee Wooden, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 845 S Main St Ste A7, Bountiful, UT 84010 Phone: 801-298-0903
Daelyn Tasha Clawson, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 390 N Main St, Bountiful, UT 84010 Phone: 801-397-6670
Mandi Spens, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 630 Medical Dr, Bountiful, UT 84010 Phone: 801-299-3781
Miss Lauren Lightfield, AGACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 458 N 500 W, Bountiful, UT 84010 Phone: 801-292-9355 Fax: 801-296-8050
Sarah Elizabeth Mcmillin, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 111 W 3100 S, Bountiful, UT 84010 Phone: 801-668-7479
Mistie Sue Manning, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 370, Bountiful, UT 84010 Phone: 801-747-7244

Shane A Archibald, RN, DNP, APRN, FNP-C - Medicare Nurse Practitioner in Bountiful, UT