Travis Light, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26618 Issued in MD

Practice address

1409 S Salisbury Blvd # CD
Salisbury, MD 21801-7151

Phone

(667) 330-1061

Fax

(410) 334-3730

NPI assigned

Sep 11, 2017

Last updated

Sep 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ati Holdings, LLC

  dba ATI Physical Therapy

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  Physical Therapist

  Medicare reassignment NPD
• Strive Sports Medicine Physical Therapy, LLC

  • Physical Therapist
  • Salisbury, MD
  • NPI 1578273629
  NPD Authorized official
• Strive Sports Medicine Physical Therapy, LLC

  • Physical Therapist
  • Fruitland, MD
  • NPI 1811504608
  NPD Authorized official
• Ati Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • King of Prussia, PA
  • NPI 1750194460

  Physical Therapist

  NPD
• Ati Holdings, LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Forest Hill, MD
  • NPI 1013109099
  NPD (past)
• Ati Holdings, LLC

  dba ATI Physical Therapy Salisbury South

  • Physical Therapist
  • Salisbury, MD
  • NPI 1972986115
  NPD (past)

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1083133102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 S SALISBURY BLVD # CD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017151",
            "telephone_number": "667-330-1061",
            "fax_number": "410-334-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "TRAVIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifes Energy Wellness Center Inc.
• Lifes Energy Wellness Center Inc.
• Lifestar Ambulance, Inc.
• Lifetime Improvement Counseling
• Lifetime Improvement Counseling
• Ghee Kheng Lim, MBBS
• Shu-Chai Willy Lin, M.D.
• Laura Beth Lind, OT/L
• Mary Beth Lindsay, MD
• Susan Ileana Lindstrom

• Physical Therapist in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.