Individual provider Active NPI

Travis Jay Canova, DO

  • Diagnostic Radiology Physician
  • Clinton, UT
National Provider Identifier
1144635269
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11629842-1204 Issued in UT
Practice address
1232 N 2560 W
Clinton, UT 84015-2773
Phone
(801) 549-7227
NPI assigned
Jun 26, 2014
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11629842-1204 UT Primary

Addresses

Primary practice location

1232 N 2560 W
Clinton, UT 84015-2773

Mailing address

1232 N 2560 W
Clinton, UT 84015-2773
Phone (801) 549-7227

Other identifiers 2

IdentifierTypeStateIssuer
200067468MedicaidMO
ENROLLEDMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201020002571 UT Practitioner - Diagnostic Radiology 7911228671 Reassigns benefits to 6 organizations
I20260106001418 TN Practitioner - Diagnostic Radiology 7911228671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Radiology Associates PAGroup PAC ID 6305893231, 28 clinicians
Tooele Valley Imaging LLCGroup PAC ID 2466624630, 24 clinicians
Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

1232 N 2560
Clinton, UT 84015-2773
Phone (731) 240-1747

2310 N 400
Suite F
Logan, UT 84341-1788
Phone (435) 258-9598

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11629842-1204UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Diagnostic Radiology CurrentSince Jan 12, 2026 Accepting new patients
Green River Radiology, P.C. Diagnostic Radiology CurrentSince Dec 15, 2021 Accepting new patients
Wasatch Imaging LLC CurrentSince Sep 15, 2024 Accepting new patients
Jackson Clinic PA CurrentSince Jan 12, 2026 Accepting new patients
Tooele Valley Imaging, LLC CurrentSince Oct 1, 2020 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology CurrentSince Dec 8, 2025 Accepting new patients
Jackson Madison County General Hospital Diagnostic Radiology CurrentSince Dec 9, 2025 Accepting new patients
Perspective Counseling Services LLC PastSince Dec 1, 2025 Accepting new patients

Locations

244 Coatsland Dr
Jackson, TN 38301
Phone (731) 422-4642

2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360

31 Sandstone Cir
Jackson, TN 38305
Phone (731) 668-0800

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

2310 N 400 E
Ste F
Logan, UT 84341
Phone (435) 258-9598

12842 S 3600 W
Ste 100
Riverton, UT 84065
Phone (385) 253-4586

9844 S 1300 E
Ste 175
Sandy, UT 84094
Phone (801) 576-1290

2356 N 400 E
Ste 103
Tooele, UT 84074
Phone (435) 882-1674

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1144635269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 N 2560 W",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840152773",
            "telephone_number": "801-549-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 N 2560 W",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840152773",
            "telephone_number": "801-549-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANOVA",
        "first_name": "TRAVIS",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "11629842-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200067468",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, UT

Sources for this page

Verify at the official NPI Registry.