Active NPI
Andrew Powell Travis, LISW, LICDC
- Clinical Social Worker
- Columbus, OH
National Provider Identifier
1164614905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I10062
- Practice address
- 1791 Alum Creek Dr
Columbus, OH 43207-1708 - Phone
- (614) 445-8131
- Fax
- (614) 324-5456
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I10062 | OH | Primary |
Addresses
Primary practice location
1791 Alum Creek Dr
Columbus, OH 43207-1708
Mailing address
1791 Alum Creek Dr
Columbus, OH 43207-1708
Phone (614) 445-8131
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4624 Sawmill Rd
Columbus, OH 43220-2247
Phone (614) 459-4490
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I10062 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Behavioral Care of Ohio, Inc | Current | Accepting new patients | |
| Optum Behavioral Care of Ohio, Inc | Current | Accepting new patients | |
| Optum Behavioral Care of Ohio, Inc. | Clinical | Current | Accepting new patients |
Locations
4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 457-4490
3055 Kettering Blvd
Ste 218
Moraine, OH 45439
Phone (937) 813-1292
Interoperability endpoints
- andrew.travis.1@28621.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Counseling Psychologist
- Columbus, OH
- NPI 1285400978
-
- Counseling Psychologist
- Columbus, OH
- NPI 1952177644
-
- Clinical Social Worker
- Maryland Heights, MO
- NPI 1528945623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1164614905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1791 ALUM CREEK DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432071708",
"telephone_number": "614-445-8131",
"fax_number": "614-324-5456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1791 ALUM CREEK DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432071708",
"telephone_number": "614-445-8131",
"fax_number": "614-324-5456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "ANDREW",
"middle_name": "POWELL",
"name_prefix": "Mr.",
"credential": "LISW, LICDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I10062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.