Individual provider Active NPI

Travis William Thompson, M.D.

  • Pediatrics Physician
  • Ravenna, OH
National Provider Identifier
1154740496
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.130607 Issued in OH
Practice address
2497 State Route 59
Ravenna, OH 44266-1641
Phone
(330) 676-1020
Fax
(330) 678-4092
NPI assigned
Apr 15, 2014
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.130607 OH Primary

Addresses

Primary practice location

2497 State Route 59
Ravenna, OH 44266-1641

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 376-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170630000527 OH Practitioner - Pediatric Medicine 3870862121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.130607OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center of Akron Current Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Jun 14, 2017 Accepting new patients
Children's Hospital Medical Center of Akron Pediatrics CurrentSince Jun 14, 2017 Accepting new patients
Akron Children's Hospital Current Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

2497 State Route 59
Ravenna, OH 44266
Phone (330) 543-2778

6847 N Chestnut St
Ste 200
Ravenna, OH 44266
Phone (330) 296-9606

Interoperability endpoints

  • Direct secure messaging: tthompson22158@direct.chmca.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1154740496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-376-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2497 STATE ROUTE 59",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442661641",
            "telephone_number": "330-676-1020",
            "fax_number": "330-678-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRAVIS",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.130607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.