The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-03-13

Foster Care Agency Primary Specialty

NUCC Taxonomy Code: 253J00000X

License # reported to NPPES AS 1372

A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.

Respite Care - Respite Care, Mental Illness, Child

NUCC Taxonomy Code: 385HR2055X

License # reported to NPPES AZ 1372

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Arizona Medical Board.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2020

Respite Care (license number reported to NPPES: AZ 1372)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) July 08, 2007

Registered at 1502 E CARSON RD, PHOENIX, AZ 850425621 (Tel: 6022767690)

📍

Business Mailing Address (Initial Record) July 08, 2007

Registered at 1502 E CARSON RD, PHOENIX, AZ 850425621 (Tel: 6022767690)

👤

Provider Name / Credentials (Initial Record) July 08, 2007

Recorded as VIRGINIA ARCHIE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Contractor (license number reported to NPPES: AZ 1372)

🟢

Initial NPI Registration & Enumeration March 26, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114045614

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 26, 2007

Last Update: March 13, 2020

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1502 E Carson Rd

Phoenix, AZ 850425621

Phone: 6022767690

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.