Edwin Jay Travis, DC CCSP CVCP ACN

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4037 Issued in TX

Practice address

45 Loop 150 W
Bastrop, TX 78602-3930

Phone

(512) 321-4481

Fax

(512) 321-9737

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Travis Chiropractic Center Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Travis Chiropractic Center, Ubo

  • Medical Specialty Clinic/Center
  • Bastrop, TX
  • NPI 1982139713
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1043369945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LOOP 150 W",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023930",
            "telephone_number": "512-321-4481",
            "fax_number": "512-321-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LOOP 150 W",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023930",
            "telephone_number": "512-321-4481",
            "fax_number": "512-321-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "EDWIN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DC  CCSP  CVCP ACN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1226201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055841",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "CENTER",
            "middle_name": "CHIROPRACTIC",
            "credential": "DC CCSP CVCP ACN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Denise Thorn
• Elizabeth Tisdale, CPM, LM
• Rudy Torres Jr.
• Tranquil Transitions
• Travis Chiropractic Center, Ubo
• Christine Ann Trevino, DO
• Benjamin Jason Trowbridge, D.C.
• Troy Alonzo Enis Jr.,Inc.
• Melissa Jacquelyn Troy
• Michelle Truong

• Chiropractor in Bastrop, TX
• Providers in Bastrop, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.