SHANE A ARCHIBALD RN, DNP, APRN, FNP-C
NPI 1861155228
Nurse Practitioner - Family in Bountiful, UT

Q: What is Shane Archibald's NPI number?

The NPI number for Shane Archibald is 1861155228. It was assigned to this individual provider in the NPPES registry on October 21, 2021.

Q: What is Shane Archibald's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Archibald was last updated on November 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since October 21, 2021PECOS Enrolled

185 S 400 E STE 100, BOUNTIFUL, UT 84010(801) 397-6200(801) 397-6201 Get Directions Write a Review

NPPES record last updated: November 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2022, Oct 21, 2021 (2 updates tracked since 2021).

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About Shane A Archibald Rn, Dnp, Aprn, Fnp-c NPPES

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

SHANE A ARCHIBALD RN, DNP, APRN, FNP-C (NPI 1861155228) is an individual family provider in Bountiful, Utah, licensed in Utah (7672413-4405) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861155228

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameSHANE A ARCHIBALDCredential: RN, DNP, APRN, FNP-C

Location Address185 S 400 E STE 100Bountiful, UT 84010-4862

Mailing AddressPo Box 5546Denver, CO 80217-5546 · (801) 475-3500 · Fax (801) 475-3414

Phone(801) 397-6200

Fax(801) 397-6201

Sole ProprietorYes

Enumeration DateOctober 21, 2021

Last NPPES UpdateNovember 11, 20222 updates tracked since enumeration

NPPES CertifiedNovember 11, 2022

✔ NPI 1861155228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in UT · 7672413-4405

185 S 400 E STE 100, Bountiful, UT 84010

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane A Archibald Rn, Dnp, Aprn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADRIAN LOPEZ ACMHC

Counselor (Mental Health)