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ARCHON MED LLC
NPI 1285213546
Emergency Medicine in Gautier, MS

Active since April 05, 2021
5090 GAUTIER VANCLEAVE RD, GAUTIER, MS 39553(228) 522-6700 Get Directions Write a Review

NPPES record last updated: April 5, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Archon Med Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ARCHON MED LLC (NPI 1285213546) is a healthcare organization registered as an emergency medicine in Gautier, Mississippi and active in the NPI registry since April 2021. The organization lists Stephen Nunenmacher, Owner, as its authorized official.

NPPES Registry Identity

NPI1285213546
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameARCHON MED LLC
Location Address5090 GAUTIER VANCLEAVE RDGautier, MS 39553-4803
Mailing Address3500 N 4th StOcean Springs, MS 39564-8534
Phone(228) 522-6700
Organization SubpartNo
Authorized OfficialStephen NunenmacherOwner · (228) 233-4404
Enumeration DateApril 5, 2021
NPPES CertifiedApril 5, 2021
✔ NPI 1285213546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
5090 GAUTIER VANCLEAVE RD, Gautier, MS 39553
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Archon Med Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Archon Med LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephen Nunenmacher
Internal Medicine
NPI 1487705042
2809 DENNY AVE
Pascagoula, MS 39581
(228) 809-5000
✔ PECOS✔ Accepts Medicare7.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Archon Med LLC's NPI number?

The NPI number for Archon Med LLC is 1285213546. It was assigned to this organization in the NPPES registry on April 5, 2021.

Where is Archon Med LLC located?

Archon Med LLC is located at 5090 Gautier Vancleave Rd, Gautier, MS 39553. The listed phone number is (228) 522-6700.

What is Archon Med LLC's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Archon Med LLC enrolled in Medicare?

Yes. Archon Med LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Archon Med LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Archon Med LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Archon Med LLC was last updated on April 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.