Active NPI
Philip M Traynor, D.P.M.
- Podiatrist
- Albertville, AL
National Provider Identifier
1124019609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 140
- Practice address
- 9625 US Highway 431
Albertville, AL 35950-0129 - Phone
- (256) 878-0971
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 140 | AL | Primary |
Addresses
Primary practice location
9625 US Highway 431
Albertville, AL 35950-0129
Mailing address
PO Box 88
Vinemont, AL 35179-0088
Phone (256) 878-0971
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000074415 | Medicaid | AL | |
| 51074415 | Other | AL | BCBS |
| 136479605 | Medicaid | TX |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1219 | TX | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long-Term Care Physicians of Alabama Inc | Past | Accepting new patients | |
| Lakeview Family Foot Care L.L.C. | Podiatrist | Past | Accepting new patients |
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.
-
- Skilled Nursing Facility
- Cullman, AL
- NPI 1194819375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532476800000",
"number": "1124019609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 88",
"city": "VINEMONT",
"state": "AL",
"postal_code": "351790088",
"telephone_number": "256-878-0971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9625 US HIGHWAY 431",
"city": "ALBERTVILLE",
"state": "AL",
"postal_code": "359500129",
"telephone_number": "256-878-0971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAYNOR",
"first_name": "PHILIP",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2018-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AL",
"license": "140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000074415",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51074415",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136479605",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albertville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.