Lucille Travis, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN195568 Issued in GA

Practice address

4095 Atlanta Hwy
Hiram, GA 30141-1854

Phone

(404) 488-9521

Fax

(404) 836-8030

NPI assigned

May 19, 2018

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care at Home Medical Practice PCGroup PAC ID 5092164533, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Care at Home Medical Practice PC

  • General Practice Physician
  • Atlanta, GA
  • NPI 1699552836
  Medicare reassignment Care Compare group NPD
• Kingdom Healthcare Services, LLC

  • Primary Care Clinic/Center
  • Hiram, GA
  • NPI 1750913349
  Medicare reassignment NPD Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1093206674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 ATLANTA HWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411854",
            "telephone_number": "404-488-9521",
            "fax_number": "404-836-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 ATLANTA HWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411854",
            "telephone_number": "404-488-9521",
            "fax_number": "404-836-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "LUCILLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-19",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN195568",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN195568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy N Timmons, CSA
• Brett Matthew Tomashitis, MD
• Total Quality Homecare
• Daniel Marc Toubiana, PA-C
• Tranquil Life Counseling Center, LLC
• Angel Tribuno, D.C.
• Trinardra Trimble, CPT
• Trinity Surgical LLC
• Trubalance Behavioral Services LLC
• True Companions Inc. Home Care Provider (True Companions Inc.)

• Primary Care Nurse Practitioner in Hiram, GA
• Providers in Hiram, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.