Justin Ray Travis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2138DT Issued in KY

Practice address

1748 Broadway St
Paducah, KY 42001-2706

Phone

(270) 443-9955

Fax

(270) 442-1469

NPI assigned

Jul 20, 2013

Last updated

Sep 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justintravis@direct.eyecare-partners.com

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.

• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597

  KY

  Medicare reassignment Care Compare group NPD
• James W. Herman, O.D.

  • Optometrist
  • Hurricane, WV
  • NPI 1376548974
  Medicare reassignment
• Clarkson Optometry Midwest Inc

  dba 20/20 EyeCare

  • Optometrist
  • Lebanon, KY
  • NPI 1366520702
  NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Clarksville, IN
  • NPI 1295772143
  NPD
• 20-20 Eyecare PSC

  • Optometrist
  • Louisville, KY
  • NPI 1710924949
  NPD (past)

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

{
    "created_epoch": "1374278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1295177152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012706",
            "telephone_number": "270-443-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012706",
            "telephone_number": "270-443-9955",
            "fax_number": "270-442-1469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 Teays Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269645",
            "country_code": "US",
            "telephone_number": "304-757-2533",
            "fax_number": "304-757-2534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "JUSTIN",
        "middle_name": "RAY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-20",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2001-IOD1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2138DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TPG PLLC (New Horizons Plastaic Surgery)
• Ashley Crooke Trader, OT
• Transformation Wellness Center LLC
• Transitions Sober Living, LLC
• Brooke Carolyn Travers
• Olivia Travis
• Sheila Travis
• Angela J Traylor
• Jakhia Traylor, RN
• Trent M. Nelson, D.M.D. P.S.C. (Bluegrass Dental Center)

• Optometrist in Paducah, KY
• Providers in Paducah, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.