Individual provider Active NPI

Travis Eric Huttner, PT

  • Physical Therapist
  • Macon, GA
National Provider Identifier
1336892918
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015753 Issued in GA
Practice address
3708 Northside Dr
Macon, GA 31210-2404
Phone
(478) 745-4206
Fax
(478) 254-5463
NPI assigned
Feb 2, 2022
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015753 GA Primary

Addresses

Primary practice location

3708 Northside Dr
Macon, GA 31210-2404

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220217000860 GA Practitioner - Physical Therapist in Private Practice 5395138259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Macon Orthopaedic & Hand Center, PA CurrentSince Feb 2, 2022 Accepting new patients
Macon Orthopaedic & Hand Center, PA Physical Therapist Current Accepting new patients
Macon Orthopaedic & Hand Center, PA CurrentSince Feb 2, 2022 Accepting new patients

Locations

2510 GA Highway 127
Kathleen, GA 31047
Phone (478) 352-7143

3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303

301 Margie Dr
Warner Robins, GA 31088
Phone (478) 953-5800

Interoperability endpoints

  • Direct secure messaging: travis.huttner.1@4291.direct.athenahealth.com

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, 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": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1336892918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTNER",
        "first_name": "TRAVIS",
        "middle_name": "ERIC",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.