Individual provider Active NPI

Travis Wasson, PSY.D, LP

  • Clinical Psychologist
  • Battle Creek, MI
National Provider Identifier
1295136919
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016084 Issued in MI
Practice address
7 Heritage Oak LN Ste 1
Battle Creek, MI 49015-4283
Phone
(269) 968-2811
Fax
(269) 968-2651
NPI assigned
Sep 12, 2014
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301016084 MI Primary

Addresses

Primary practice location

7 Heritage Oak LN Ste 1
Battle Creek, MI 49015-4283

Mailing address

7 Heritage Oak LN Ste 1
Battle Creek, MI 49015-4283
Phone (269) 968-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327000144 MI Practitioner - Clinical Psychologist 7911269204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological Consultants of Michigan, P.C.Group PAC ID 7517943830, 2 clinicians

Practice addresses (Care Compare)

7 Heritage Oak LN
Suite 1
Battle Creek, MI 49015-4283
Phone (269) 968-2811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Consultants of Michigan, P.C. CurrentSince Mar 19, 2018 Accepting new patients
Psychological Consultants of Mi, P.C. Past Accepting new patients

Locations

151 North Ave
Battle Creek, MI 49017
Phone (269) 968-2811

7 Heritage Oak Ln
Ste 1
Battle Creek, MI 49015
Phone (269) 968-2811

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1295136919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HERITAGE OAK LN STE 1",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154283",
            "telephone_number": "269-968-2811",
            "fax_number": "269-968-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HERITAGE OAK LN STE 1",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154283",
            "telephone_number": "269-968-2811",
            "fax_number": "269-968-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSON",
        "first_name": "TRAVIS",
        "credential": "PSY.D, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.