Individual provider Active NPI

Travis G. Groft, PH.D.

  • Clinical Neuropsychologist
  • Lincoln, NE
National Provider Identifier
1326139254
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
322 Issued in NE
Practice address
5401 South St
Lincoln, NE 68506-2150
Phone
(402) 413-3547
Fax
(402) 413-4604
NPI assigned
Sep 27, 2006
Last updated
Aug 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 322 NE Primary
Psychologist 103T00000X 322 NE

Addresses

Primary practice location

5401 South St
Lincoln, NE 68506-2150

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (402) 413-3547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217001086 NE Practitioner - Clinical Psychologist 3577457415 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Madonna Rehabilitation Hospital CurrentSince Nov 1, 2003 Accepting new patients
Rod W. Kohl, P.C. Past Accepting new patients

Locations

5401 South St
Lincoln, NE 68506
Phone (402) 413-3000

17500 Burke St
Omaha, NE 68118
Phone (402) 401-3000

Organizations & group practices 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1326139254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-413-3547",
            "fax_number": "402-413-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-413-3547",
            "fax_number": "402-413-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROFT",
        "first_name": "TRAVIS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NE",
            "license": "322",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.