Individual provider Active NPI

Regina Irene Travis, D.O.

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1093001745
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13374 Issued in FL
Practice address
4642 Balboa Park Loop
Bradenton, FL 34211-4960
Phone
(973) 229-4223
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS13374 FL Primary
Hospitalist Physician 208M00000X OS13374 FL

Addresses

Primary practice location

4642 Balboa Park Loop
Bradenton, FL 34211-4960

Mailing address

943 S Beneva Rd
Suite 306
Sarasota, FL 34232-2476
Phone (941) 362-8644

Other practice location 1

943 S Beneva Rd
Suite 306
Sarasota, FL 34232-2476
Phone (941) 362-8644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201001371 FL Practitioner - Internal Medicine 9234447418 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS13374FLMDInternal Medicine Physician

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1093001745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 S BENEVA RD",
            "address_2": "SUITE 306",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322476",
            "telephone_number": "941-362-8644",
            "fax_number": "941-954-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4642 BALBOA PARK LOOP",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114960",
            "telephone_number": "973-229-4223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 S Beneva Rd",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342322476",
            "country_code": "US",
            "telephone_number": "941-362-8644",
            "fax_number": "941-954-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "REGINA",
        "middle_name": "IRENE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13374",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS13374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.