Active NPI
Travis Nathan Allen, PT, DPT
- Physical Therapist
- Tooele, UT
National Provider Identifier
1164688347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 350200-2401
- Practice address
- 1226 N Main St
Tooele, UT 84074-9540 - Phone
- (435) 843-1311
- Fax
- (435) 843-9846
- NPI assigned
- Aug 6, 2008
- Last updated
- Dec 4, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 350200-2401 | UT | Primary |
Addresses
Primary practice location
1226 N Main St
Tooele, UT 84074-9540
Mailing address
PO Box 307
Bountiful, UT 84011-0307
Phone (801) 294-6907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 350200-2401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blake R. Beazer, M.D., Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Tooele, UT
- NPI 1184807992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1164688347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 307",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840110307",
"telephone_number": "801-294-6907",
"fax_number": "801-294-6917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1226 N MAIN ST",
"city": "TOOELE",
"state": "UT",
"postal_code": "840749540",
"telephone_number": "435-843-1311",
"fax_number": "435-843-9846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "TRAVIS",
"middle_name": "NATHAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-06",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "350200-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.