Active NPI
Travis Dubois, PHARMD
- Pharmacist
- Washington, NC
National Provider Identifier
1063775401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21827
- Practice address
- 1316 John Small Ave
Washington, NC 27889-3843 - Phone
- (252) 623-2100
- Fax
- (252) 623-2013
- NPI assigned
- Jun 20, 2012
- Last updated
- Sep 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21827 | NC | Primary |
Addresses
Primary practice location
1316 John Small Ave
Washington, NC 27889-3843
Mailing address
1316 John Small Ave
Washington, NC 27889
Phone (252) 623-2100
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21827 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinetops Pharmacy, Inc. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Pinetops, NC
- NPI 1912516287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1063775401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 JOHN SMALL AVE",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "27889",
"telephone_number": "252-623-2100",
"fax_number": "252-623-2013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1316 JOHN SMALL AVE",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893843",
"telephone_number": "252-623-2100",
"fax_number": "252-623-2013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOIS",
"first_name": "TRAVIS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-20",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, NC
- Dream Provider Care Services, Inc
- Dream Provider Care Services, Inc.
- Dream Provider Care Services, Inc.
- Dream Provider Care Services, Inc.
- Dream Provider Care Services, Inc.
- Joyce Elaine Dunn, PTA
- John Wesley Earley, MD
- Courtney Elizabeth Early, LCMHCA, NCC
- East Carolina Health-Beaufort Inc (Ray G. Silverthorne Crisis Center)
- East Carolina Health-Beaufort Inc (Vidant Beaufort Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.