Mary Ann Travillian, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3015476 Issued in KY

Practice address

204 N Main St
Elizabethtown, KY 42701-1417

Phone

(270) 360-1222

Fax

(270) 360-0333

NPI assigned

May 18, 2020

Last updated

Dec 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Options, Inc.Group PAC ID 3072507276, 2 clinicians

Elizabethtown Partners in Counseling IncGroup PAC ID 7719911023, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elizabethtown Partners in Counseling Inc

  • Psychologist
  • Elizabethtown, KY
  • NPI 1841399789
  Medicare reassignment Care Compare group NPD
• Family Options Inc

  • Clinical Social Worker
  • Morgantown, KY
  • NPI 1356327076
  Medicare reassignment Care Compare group NPD
• Family Options, Inc

  • Clinical Social Worker
  • Owensboro, KY
  • NPI 1205226982
  NPD (past)
• Family Options, Inc.

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1558532853
  NPD (past)

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1306469994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N MAIN ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011417",
            "telephone_number": "270-360-1222",
            "fax_number": "270-360-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N MAIN ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011417",
            "telephone_number": "270-360-1222",
            "fax_number": "270-360-0333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Bald Knob Rd",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "KY",
            "postal_code": "423209402",
            "country_code": "US",
            "telephone_number": "270-256-7473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVILLIAN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3015476",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1106020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mhmadrt@gmail.com",
            "affiliation": "N",
            "address_1": "811 E Parrish Ave",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423033258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Justin Thomas Travis, DPT
• Lori S. Travis, AU.D.
• Chaney Troutman, PA-C
• True North Healthcare Center
• Roxanne Ognibene True, MS LD RD

• Psychiatric/Mental Health Nurse Practitioner in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.