Individual provider Active NPI

Travis Jewell Null, FNP

  • Family Nurse Practitioner
  • Albany, MO
National Provider Identifier
1083084875
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015035371 Issued in MO
Practice address
1607 E US Highway 136
Albany, MO 64402-8223
Phone
(660) 726-3333
Fax
(660) 726-3232
NPI assigned
Oct 6, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015035371 MO Primary

Addresses

Primary practice location

1607 E US Highway 136
Albany, MO 64402-8223

Mailing address

1607 E US Highway 136
Albany, MO 64402-8223
Phone (660) 726-3333

Other practice location 1

202 E Main St
Stanberry, MO 64489-1358
Phone (660) 783-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160125002851 MO Practitioner - Nurse Practitioner 4284937251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1607 E US Hwy 136
Mosaic Family Care Albany East
Albany, MO 64402-8223
Phone (660) 726-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.47 of 100Reported as group
Quality
81.87
Promoting interoperability
99
Improvement activities
40
Cost
30.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015035371MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Center Association Inc CurrentSince Dec 4, 2015 Accepting new patients
Northwest Medical Center Association, Inc CurrentSince Dec 4, 2015 Accepting new patients

Locations

1607 E US Highway 136
Albany, MO 64402
Phone (660) 726-3333

705 N College St
Albany, MO 64402
Phone (660) 726-3941

202 E Main St
Stanberry, MO 64489
Phone (660) 783-2092

Interoperability endpoints

  • Direct secure messaging: travis.null@direct.mymlc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083084875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E US HIGHWAY 136",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644028223",
            "telephone_number": "660-726-3333",
            "fax_number": "660-726-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E US HIGHWAY 136",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644028223",
            "telephone_number": "660-726-3333",
            "fax_number": "660-726-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 E Main St",
            "address_purpose": "LOCATION",
            "city": "Stanberry",
            "state": "MO",
            "postal_code": "644891358",
            "country_code": "US",
            "telephone_number": "660-783-2192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NULL",
        "first_name": "TRAVIS",
        "middle_name": "JEWELL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015035371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, MO

Sources for this page

Verify at the official NPI Registry.