Individual provider Active NPI

Travis Stickle, D.C.

  • Chiropractor
  • Lynchburg, VA
National Provider Identifier
1306921200
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104555954 Issued in VA
Practice address
20370A Timberlake Rd
Lynchburg, VA 24502-7213
Phone
(434) 238-0881
NPI assigned
Oct 26, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104555954 VA Primary

Addresses

Primary practice location

20370A Timberlake Rd
Lynchburg, VA 24502-7213

Mailing address

20370A Timberlake Rd
Lynchburg, VA 24502-7213
Phone (434) 238-0881

Other identifiers 2

IdentifierTypeStateIssuer
P00057525OtherVARAILROAD MEDICARE PIN
DA3963OtherVARAILROAD MEDICARE UPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406000410 VA Practitioner - Chiropractic 0840283818 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104555954VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Covington Chiropractic Inc Chiropractor CurrentSince Jun 30, 2003 Accepting new patients
The Spine Center of Roanoke Valley, Inc. Chiropractor Past Accepting new patients
Chiropractic Health Center Inc Chiropractor PastSince Nov 2, 2015 Accepting new patients

Locations

222 N Court Ave
Covington, VA 24426
Phone (540) 962-0809

Organizations & group practices 4

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1306921200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20370A TIMBERLAKE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027213",
            "telephone_number": "434-238-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20370A TIMBERLAKE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027213",
            "telephone_number": "434-238-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLE",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00057525",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE UPIN",
            "identifier": "DA3963",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.