NPIMap

Individual provider Active NPI

Travis M Daise, MD

  • Family Medicine Physician
  • Goodland, KS
National Provider Identifier
1184621997
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-29442 Issued in KS
Practice address
106 Willow Rd
Goodland, KS 67735-1518
Phone
(785) 890-6075
Fax
(785) 890-6077
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-29442 KS Primary

Addresses

Primary practice location

106 Willow Rd
Goodland, KS 67735-1518

Mailing address

106 Willow Rd
Goodland, KS 67735-1518
Phone (785) 890-6075

Other identifiers 2

IdentifierTypeStateIssuer
1184621997OtherKSBCBS
200180020BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412001397 KS Practitioner - Family Practice 0143214239 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodland Regional Medical CenterGroup PAC ID 3375535263, 22 clinicians
Rawlins County Health CenterGroup PAC ID 4688585151, 9 clinicians

Practice addresses (Care Compare)

106 Willow Rd
Goodland, KS 67735-1518
Phone (785) 890-6012

707 Grant St
Atwood, KS 67730-1526
Phone 78562632112205

Hospital & facility affiliations

  • Good Samaritan Society Northwest Kansas Home Care Home health agency, St Francis, KS, CCN 178050
  • L & C Home Health Agency Inc Home health agency, Colby, KS, CCN 178055
  • Hospice Services Inc Hospice, Phillipsburg, KS, CCN 171515
  • Goodland Regional Medical Center Hospital, Goodland, KS, CCN 171370
  • Kit Carson County Memorial Hospital Hospital, Burlington, CO, CCN 061313
  • Rawlins County Health Center Hospital, Atwood, KS, CCN 171307
  • Cheyenne County Hospital Hospital, St Francis, KS, CCN 171310
  • Citizens Medical Center Hospital, Colby, KS, CCN 171362
  • Topside Manor Inc Nursing home, Goodland, KS, CCN 175361
  • Grace Manor Care Center Nursing home, Burlington, CO, CCN 065284
  • Good Samaritan - Atwood Nursing home, Atwood, KS, CCN 175366
  • Goodland Regional Medical Center Nursing home, CCN 17Z370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-29442KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rawlins County Health Center CurrentSince Aug 1, 2020 Accepting new patients
Goodland Regional Medical Center Current Accepting new patients
Goodland Regional Medical Center CurrentSince Jul 1, 2025 Accepting new patients
Rawlins County Health Center CurrentSince Aug 1, 2020 Accepting new patients
Rawlins County Health Center Current Accepting new patients
Goodland Regional Medical Center CurrentSince Mar 1, 2004 Accepting new patients
Goodland Regional Medical Center Family Medicine CurrentSince Mar 1, 2004 Accepting new patients
Topside Manor Inc Past Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
Great Plains of Cheyenne Co. Inc Past Accepting new patients

Locations

707 Grant St
Atwood, KS 67730
Phone (785) 626-3211

106 Willow Rd
Goodland, KS 67735
Phone (785) 890-6012

220 W 2nd St
Goodland, KS 67735
Phone (785) 890-3625

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13372/brand/1/csg/1/fhir/r4
  • Direct secure messaging: travis.daise.1@17074.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grace Manor Care CenterBurlington, CO, CCN 065284 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2022
Mar 1, 2022
Reliant Pro Rehab, LLCGoodland, KS, CCN 175361 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 12

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1184621997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-6075",
            "fax_number": "785-890-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-6075",
            "fax_number": "785-890-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAISE",
        "first_name": "TRAVIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-29442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1184621997",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200180020B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodland, KS

Sources for this page

Verify at the official NPI Registry.