CMS-1500 Box 24J / 33a • NPI
1295774412
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AM0700X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical
Box 32 Service Location & ZIP+4
905 E COLBY ST, WHITEHALL, MI, 49461-1262
✓ 9-Digit EDI 837 ZIP+4 (49461-1262)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1295774412 (JOHN JAMES ARCHAMBEAULT, PA-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1295774412 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JOHN JAMES ARCHAMBEAULT, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: 363AM0700X (Physician Assistant, Medical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 905 E COLBY ST, WHITEHALL, MI, 49461-1262 |
| Practice Telephone / Fax | Tel: (231) 728-5910 | Fax: (231) 728-5918 |
| Administrative Mailing Address | 4777 PINNACLE CT SW, WYOMING, MI, 49519-4950 |
| Enumeration & Last Sync | Enumerated: 2006-06-05 | CMS Record Updated: 2026-07-13 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)
What Does Taxonomy Code 363AM0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JOHN JAMES ARCHAMBEAULT, PA-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: MI | License: 5601001906 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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