Travis B Grindstaff, M.D., MPHB

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

81558 Issued in SC

Practice address

4700 Las Vegas Blvd N BLDG 1300
Nellis AFB, NV 89191-6600

Phone

(702) 653-2766

NPI assigned

Apr 10, 2017

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

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1275066821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N BLDG 1300",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N BLDG 1300",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDSTAFF",
        "first_name": "TRAVIS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D., MPHB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "SC",
            "license": "81558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tavyia Gooding, PHARMD
• Joshua J Gormley, MD
• Elena M Gray, PT, DPT
• Gary Walter Grear
• Frederick P Griffith IV, MD
• Michael Gross, DO
• Michael Gu, DDS
• Nicholas Paul Gualtieri, DO
• John G Guse, PA-C
• Edward S Ha, R.N., CRNA

• Aerospace Medicine Physician in Nellis AFB, NV
• Providers in Nellis AFB, NV by specialty
• Aerospace Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.