Individual provider Active NPI

Henry Travers, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Sioux Falls, SD
National Provider Identifier
1194723924
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2710 Issued in SD
Practice address
1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019
Phone
(605) 322-7200
Fax
(605) 322-7222
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 18482 KS
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 47381 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20077 NC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 23096 NE
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2710 SD Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 101022782 VA

Addresses

Primary practice location

1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019

Mailing address

1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019
Phone (605) 322-7200

Other identifiers 1

IdentifierTypeStateIssuer
399365500OtherMNMEDICAID

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18482KSMDAnatomic Pathology & Clinical Pathology Physician
47381MNMDAnatomic Pathology & Clinical Pathology Physician
20077NCMDAnatomic Pathology & Clinical Pathology Physician
23096NEMDAnatomic Pathology & Clinical Pathology Physician
101022782VAMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1194723924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE",
            "address_2": "SUITE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051019",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE",
            "address_2": "SUITE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051019",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVERS",
        "first_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "18482",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "47381",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "20077",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "23096",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SD",
            "license": "2710",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "101022782",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "399365500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.