Travis Wayne McClintock, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301084373 Issued in MI

Practice address

1535 Gull Rd
MSB 015
Kalamazoo, MI 49048-1650

Phone

(269) 226-6933

Fax

(269) 226-6949

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Emergency Medicine

Education

Loma Linda University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1912687328
  Medicare reassignment Care Compare group NPD
• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Medicare reassignment NPD
• Elite Emergency Physicians of Michigan PC

  • Emergency Medicine Physician
  • Three Rivers, MI
  • NPI 1427730050
  Medicare reassignment NPD
• Ascension Borgess Hospital

  • Urgent Care Clinic/Center
  • Portage, MI
  • NPI 1417130154
  NPD
• Ascension Borgess Hospital

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
  • NPI 1518753441
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Three Rivers, MI
  • NPI 1881498202
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Three Rivers Health System, Inc

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1184843682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "MSB 015",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-226-6933",
            "fax_number": "269-226-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "MSB 015",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-226-6933",
            "fax_number": "269-226-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "TRAVIS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301084373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105190445",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "TM084373",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP-TR HEALTH",
            "identifier": "0G56008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP-THREE RIVERS HEALTH",
            "identifier": "700G560080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myah McClain
• Tonya Delita McClain, AOP, HHA
• Allyson McClellan, LMSW
• Alexandria L McClenton
• Janae McClenton
• Kati McClish
• Emily McCollum
• Katherine McCollum, MD
• Sarah A McCollum, M.S. CCC-SLP
• Tracy McConnell

• Emergency Medicine Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.

Verify at the official NPI Registry.