Travis Reynolds, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

6525 Issued in MN

Practice address

14051 Burnhaven Dr Ste 104
Burnsville, MN 55337-4400

Phone

(952) 492-9043

NPI assigned

Nov 7, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Optimum Chiropractic & Performance Rehab, PLLC

  • Primary Care Clinic/Center
  • Burnsville, MN
  • NPI 1417502493
  NPD (past) Authorized official

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1194293258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 BURNHAVEN DR STE 104",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374400",
            "telephone_number": "952-492-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14051 BURNHAVEN DR STE 104",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374400",
            "telephone_number": "952-492-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "6525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resurgence Chiropractic Clinic LLC
• Revive Periodontics and Implants
• Brittany Reye, NTM
• Pamela Lynn Reynolds-Klocke
• Michael Thomas Reynolds, D.D.S.
• Eric Rheault
• John D Rhoades, M.D.
• Anna Rice
• Colleen Rice
• Catherine Opeoluwa Richards

• Rehabilitation Chiropractor in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Rehabilitation Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.