Individual provider Active NPI

Travis Christopher Stephens, O.D.

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1306295894
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004064 Issued in IN
Practice address
608 E Boulevard
Kokomo, IN 46902-2271
Phone
(765) 453-5005
Fax
(765) 453-8937
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004064 IN Primary
Optometrist 152W00000X OPT.6497 OH

Addresses

Primary practice location

608 E Boulevard
Kokomo, IN 46902-2271

Mailing address

608 E Boulevard
Kokomo, IN 46902-2271
Phone (740) 391-8233

Other practice location 1

1540 Spring Valley Dr
Huntington, WV 25704-9300
Phone (304) 429-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170911000302 IN Practitioner - Optometry 8325319361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decleene Optometry, Inc.Group PAC ID 3274578265, 3 clinicians

Practice addresses (Care Compare)

608 E Boulevard
Kokomo, IN 46902-2271
Phone (765) 453-5005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004064INMDOptometrist
OPT.6497OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Decleene Optometry, Inc. Optometrist CurrentSince Aug 23, 2017 Accepting new patients
Marion Family Optometrists, Inc. Optometrist CurrentSince Nov 27, 2017 Accepting new patients
Marion Family Optometrists, Inc. Optometrist CurrentSince Nov 27, 2017 Accepting new patients

Locations

608 E Boulevard
Kokomo, IN 46902
Phone (317) 817-1414

506 S Washington St
Marion, IN 46953
Phone (765) 662-6648

905 Manchester Ave
Wabash, IN 46992
Phone (260) 563-0884

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1306295894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022271",
            "telephone_number": "740-391-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022271",
            "telephone_number": "765-453-5005",
            "fax_number": "765-453-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Spring Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257049300",
            "country_code": "US",
            "telephone_number": "304-429-6741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "TRAVIS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004064",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.6497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.