Travis Yates, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

9830 Issued in MS

Practice address

Rebel Drive
Student Health Center
University, MS 38677

Phone

(662) 915-7274

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chickasaw Emergency Group LLC

  • Medical Physician Assistant
  • Houston, MS
  • NPI 1134215478

  Emergency Medicine

  NPD (past)
• Southern Health Corp. of Houston, Inc

  • Rural Health Clinic/Center
  • Houston, MS
  • NPI 1083721732
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915

  Emergency Medicine

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2008.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1003853045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 QUIET VALLEY CV",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386558430",
            "telephone_number": "662-234-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REBEL DRIVE",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "UNIVERSITY",
            "state": "MS",
            "postal_code": "38677",
            "telephone_number": "662-915-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "TRAVIS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "9830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbie Brooke Williams
• Anne Lloyd Williams, AU.D.
• Ashley Bonck Wilson, MHR, ATC, LAT
• Jasmine Wright
• Courtney Wynn

• All providers in University, MS
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.