NPIMap

Individual provider Active NPI

Travis Gustafson Elbert, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1295383644
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09425 Issued in NC
Practice address
1509 Doctors Cir BLDG C
Wilmington, NC 28401-7403
Phone
(910) 662-7500
Fax
(910) 662-7501
NPI assigned
Aug 29, 2019
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 0010-09425 NC Primary

Addresses

Primary practice location

1509 Doctors Cir BLDG C
Wilmington, NC 28401-7403

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 334-7800

Other practice location 1

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 334-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address telbert293230@direct.vidanthealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424002347 NC Practitioner - Physician Assistant 9638509052 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

800 Jefferson St
Suite 112
Whiteville, NC 28472-3702
Phone (910) 662-9500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-09425NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital Inc. CurrentSince Nov 9, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 15, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 18, 2019 Accepting new patients
NMG Health Services LLC CurrentSince Oct 22, 2022 Accepting new patients
Novant Medical Group Inc CurrentSince Aug 15, 2023 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Oct 22, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Nov 9, 2022 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1509 Doctors Cir
Bldg C
Wilmington, NC 28401
Phone (910) 662-7550

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: telbert1101735@direct.novanthealth.org
  • Direct secure messaging: telbert293230@direct.vidanthealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1295383644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DOCTORS CIR BLDG C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-662-7500",
            "fax_number": "910-662-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Morehead St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282022742",
            "country_code": "US",
            "telephone_number": "704-334-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELBERT",
        "first_name": "TRAVIS",
        "middle_name": "GUSTAFSON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "telbert293230@direct.vidanthealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.