Active NPI
Travis Elliott, LPTA
- Physical Therapy Assistant
- Bedford, VA
National Provider Identifier
1093373300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306605347
- Practice address
- 1229 County Farm Rd
Bedford, VA 24523-3131 - Phone
- (540) 586-7658
- NPI assigned
- Jun 1, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306605347 | VA | Primary |
Addresses
Primary practice location
1229 County Farm Rd
Bedford, VA 24523-3131
Mailing address
1114 Gables Dr Apt 203
Forest, VA 24551-4808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306605347 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559347200000",
"number": "1093373300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 GABLES DR APT 203",
"city": "FOREST",
"state": "VA",
"postal_code": "245514808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 COUNTY FARM RD",
"city": "BEDFORD",
"state": "VA",
"postal_code": "245233131",
"telephone_number": "540-586-7658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "TRAVIS",
"name_prefix": "Mr.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-01",
"last_updated": "2019-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306605347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.