Individual provider Active NPI

Chelsea Monique Travis, MD

  • Family Medicine Physician
  • Marquette, MI
National Provider Identifier
1144963372
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351053296 Issued in MI
Practice address
1414 W Fair Ave Ste 36
Marquette, MI 49855-2675
Phone
(906) 449-1121
Fax
(906) 225-7667
NPI assigned
Apr 15, 2022
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4351053296 MI Primary

Addresses

Primary practice location

1414 W Fair Ave Ste 36
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave Ste 36
Marquette, MI 49855-2675
Phone (906) 449-1121

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (919) 210-7201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622002129 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1557740560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351053296MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: chelsea.travis.1@8233.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1144963372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-449-1121",
            "fax_number": "906-225-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-449-1121",
            "fax_number": "906-225-7667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "919-210-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "CHELSEA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351053296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.