Travis Doom, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1370802 Issued in TX

Practice address

413 W Bethel Rd Ste 400
Coppell, TX 75019-4477

Phone

(972) 304-9100

Fax

(972) 304-9048

NPI assigned

Apr 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1346746195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 E BELTLINE LN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259432",
            "telephone_number": "616-361-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W BETHEL RD STE 400",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194477",
            "telephone_number": "972-304-9100",
            "fax_number": "972-304-9048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2816 E Beltline Ln NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495259432",
            "country_code": "US",
            "telephone_number": "616-361-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOOM",
        "first_name": "TRAVIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501018298",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1370802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Dillen
• Divine Safe and Reliable Non Medical Emergency Transportation Company
• Ryan Maxwell Dixon, PT
• Docculi Medical Group PLLC
• Daniel James Dodge, D.C.
• Dove Counseling Service PLLC
• Amber Downs
• Dr. Mac'S Pediatrics and Allergy, P.a.
• Dr. Murphy Medical Care P.a.
• Asia Draper, BCBA

• Physical Therapist in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.