Travis Hugh Williamson, DNP, CNP, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Spearfish, SD
NPI 1043882228 · NPPES record last updated Nov 10, 2023
Key facts
- NPI
- 1043882228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- CP002830 (SD)
- Practice address
- 115 N 7TH St Ste 6
Spearfish, SD 57783-2710 - Phone
- (605) 645-0100
- Fax
- (605) 717-1009
- NPI assigned
- Jul 15, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP002830 | SD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black Hills Psychology, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
115 N 7th St
Ste 6
Spearfish, SD 57783
Phone (605) 645-0100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CP002830 | SD | Yes |
Addresses
Primary practice location
115 N 7TH St Ste 6
Spearfish, SD 57783-2710
Mailing address
115 N 7TH St Ste 6
Spearfish, SD 57783-2710
Phone (605) 645-0100
Other providers in Spearfish, SD
- William Blauer DDS PLLC
- Arik Michael Williams
- Athena M Williams
- Heidi Marie Williams I
- Melissa Williams
- Willow and Company
- Megan Doneen Wilson
- Nichole Jane Winckler
- Debra L Winter
- Janice Wolfe
All providers in Spearfish, SD · Psychiatric/Mental Health Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.