Individual provider Active NPI

Travis Scott Burch

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1063718005
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
140 South Holly Street
Medford, OR 97501
Phone
(541) 500-8655
Fax
(541) 774-7964
NPI assigned
Feb 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

140 South Holly Street
Medford, OR 97501

Mailing address

140 South Holly Street
Medford, OR 97501
Phone (541) 774-8200

Other names 1

  • Travis Burch Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Travis Scott Burch CurrentSince Mar 1, 2020 Accepting new patients
Peace in Mind Counseling PastSince Dec 15, 2019 Accepting new patients

Locations

1040 Crater Lake Ave
Ste D
Medford, OR 97504
Phone (435) 216-6073

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1063718005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SOUTH HOLLY STREET",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-774-8200",
            "fax_number": "541-774-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SOUTH HOLLY STREET",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-500-8655",
            "fax_number": "541-774-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "TRAVIS",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "BURCH",
            "credential": "MA COUNSELING",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.