Individual provider Active NPI

Travis Jayson Worth

  • Hearing Instrument Specialist
  • Oshkosh, WI
National Provider Identifier
1063802494
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1458-60 Issued in WI
Practice address
2040 W 9TH Ave Ste 3
Oshkosh, WI 54904-8730
Phone
(920) 350-9973
NPI assigned
Jan 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1458-60 WI Primary

Addresses

Primary practice location

2040 W 9TH Ave Ste 3
Oshkosh, WI 54904-8730

Mailing address

506 E Longview Dr
Appleton, WI 54911-2105

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

State licenses

LicenseStateTypeSpecialty
1458-60WIMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1063802494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 E LONGVIEW DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W 9TH AVE STE 3",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048730",
            "telephone_number": "920-350-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTH",
        "first_name": "TRAVIS",
        "middle_name": "JAYSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1458-60",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.