Individual provider Active NPI

Travis Lee Bland, CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1174193254
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN.459794 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 480-3658
Fax
(330) 480-3439
NPI assigned
Jun 30, 2021
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN.459794 OH Primary
Registered Nurse 163W00000X 459794 OH

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

4135 Boardman Canfield Rd Ste 101
Canfield, OH 44406-9803
Phone (330) 286-5330

Other practice location 1

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-4100

Other practice location 2

8401 Market St
Youngstown, OH 44512-6725
Phone (330) 729-2929

Other identifiers 3

IdentifierTypeStateIssuer
15492136OtherCAQH
PENDINGMedicaidOH
PENDINGOtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220208001272 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042603466 Reassigns benefits to 1 organization
I20251223001588 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042603466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bel-Park Anesthesia Associates, Inc.Group PAC ID 8628974904, 158 clinicians
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
459794OHMDRegistered Nurse
RN.459794OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 31, 2022 Accepting new patients
Mountain View Hospital LLC CurrentSince Oct 15, 2025 Accepting new patients
Penn-Ohio Associates in Anesthesiology, LLC Past Accepting new patients
Melius Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

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.

Hospital & facility affiliations 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1174193254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD STE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-3658",
            "fax_number": "330-480-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "667 Eastland Ave SE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444844503",
            "country_code": "US",
            "telephone_number": "330-841-4100",
            "fax_number": "330-286-5396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-2929",
            "fax_number": "330-286-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAND",
        "first_name": "TRAVIS",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.459794",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "459794",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15492136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.