Individual provider Active NPI

Travis Stehouwer

  • Audiologist
  • Falls Church, VA
National Provider Identifier
1073022315
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001681 Issued in VA
Practice address
300 N Washington St Ste 102a
Falls Church, VA 22046-3441
Phone
(703) 237-2716
NPI assigned
Sep 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01437 MD
Audiologist-Hearing Aid Fitter 237600000X VA
Audiologist 231H00000X 2201001681 VA Primary

Addresses

Primary practice location

300 N Washington St Ste 102a
Falls Church, VA 22046-3441

Mailing address

1320 Old Chain Bridge Rd Ste 185
MC Lean, VA 22101-3945
Phone (703) 942-8110

Other practice location 1

133 Rollins Ave Ste 2
Rockville, MD 20852-4040
Phone (301) 468-7670

Other practice location 2

1320 Old Chain Bridge Rd Ste 180
Mc Lean, VA 22101-3919
Phone (703) 942-8110

Other practice location 3

1320 Old Chain Bridge Rd Ste 185
Mc Lean, VA 22101
Phone (703) 942-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171128001479 DC Practitioner - Qualified Audiologist 3971860073 Reassigns benefits to 1 organization
I20171211002682 VA Practitioner - Qualified Audiologist 3971860073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Had Management, LLCGroup PAC ID 9032461892, 6 clinicians

Practice addresses (Care Compare)

300 N Washington St
Suite 102a
Falls Church, VA 22046-3441
Phone (703) 237-0163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01437MDMDAudiologist
2201001681VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Had Management LLC Audiologist CurrentSince Aug 25, 2018 Accepting new patients

Locations

133 Rollins Ave
Ste 2
Rockville, MD 20852
Phone (301) 231-9520

3930 Pender Dr
Ste 140
Fairfax, VA 22030
Phone (571) 432-0640

300 N Washington St
Ste 102A
Falls Church, VA 22046
Phone (703) 237-0163

1320 Old Chain Bridge Rd
Ste 180
Mc Lean, VA 22101
Phone (703) 942-8110

1320 Old Chain Bridge Rd
Ste 185
McLean, VA 22101
Phone (703) 866-8819

46045 Palisade Pkwy
Ste 200
Potomac Falls, VA 20165
Phone (703) 723-9672

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1073022315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OLD CHAIN BRIDGE RD STE 185",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013945",
            "telephone_number": "703-942-8110",
            "fax_number": "703-942-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N WASHINGTON ST STE 102A",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463441",
            "telephone_number": "703-237-2716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Rollins Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208524040",
            "country_code": "US",
            "telephone_number": "301-468-7670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Old Chain Bridge Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013919",
            "country_code": "US",
            "telephone_number": "703-942-8110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Old Chain Bridge Rd Ste 185",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "22101",
            "country_code": "US",
            "telephone_number": "703-942-8110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEHOUWER",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01437",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.