Active NPI
Premiant Inc
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
National Provider Identifier
1124139340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 3639
- Legal business name
- PREMIANT INC
- Practice address
- 9112 Japonica Court
Austin, TX 78748 - Phone
- (512) 916-1632
- Fax
- (512) 916-1639
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dennis R Latimer
- Title
- Ceo
- Phone
- (512) 916-1632
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 3639 | TX | Primary |
Addresses
Primary practice location
9112 Japonica Court
Austin, TX 78748
Mailing address
1110 West William Cannon
Building 2
Austin, TX 78745
Phone (512) 916-1632
Other names 1
- Travis House
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G363
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- TRAVIS GROUP HOME
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Feb 2, 1990
- Last certification
- Jan 7, 2026
- Beds
- 6
- Ownership / control type
- Private (proprietary)
- Facility address
- 9112 Japonica CT
Austin, TX 78748
National Provider Directory
National Provider Directory- Tax ID family
- Premient Inc
Other organizations with this tax ID 27
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- San Antonio, TX
- NPI 1295895837
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1053414417
-
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1134760002
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1144323502
-
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1215588959
-
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1225792070
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1235232695
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1235240300
-
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1275290462
-
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1306599121
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1326141789
-
- Adult Care Home Facility
- San Antonio, TX
- NPI 1336207299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1124139340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 WEST WILLIAM CANNON",
"address_2": "BUILDING 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78745",
"telephone_number": "512-916-1632",
"fax_number": "512-916-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9112 JAPONICA COURT",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78748",
"telephone_number": "512-916-1632",
"fax_number": "512-916-1639"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIANT INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LATIMER",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "512-916-1632",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "TX",
"license": "3639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Travis House",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.