Theresa a. Travis,M.D.,PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

01036752A Issued in IN

Legal business name

THERESA A. TRAVIS,M.D.,PC

Practice address

2516 Q St
Suite B
Bedford, IN 47421-4928

Phone

(812) 275-3328

Fax

(812) 279-5977

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Ann Travis, M.D.

Title

M.D.

Phone

(812) 275-3328

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank Boateng, M.D

  • Nephrology Physician
  • Newark, OH
  • NPI 1609025527

  Nephrology

  NPD

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1265634711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 Q ST",
            "address_2": "SUITE B",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474214928",
            "telephone_number": "812-275-3328",
            "fax_number": "812-279-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 Q ST",
            "address_2": "SUITE B",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474214928",
            "telephone_number": "812-275-3328",
            "fax_number": "812-279-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA A. TRAVIS,M.D.,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "812-275-3328",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01036752A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bedford, IN
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.