Active NPI
Michael Wayne Traylor, PT
- Physical Therapist
- Trumann, AR
National Provider Identifier
1366798704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 3469
- Practice address
- 305 W Main St
Trumann, AR 72472-3114 - Phone
- (870) 483-6131
- Fax
- (870) 483-2573
- NPI assigned
- Aug 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 3469 | AR | Primary |
Addresses
Primary practice location
305 W Main St
Trumann, AR 72472-3114
Mailing address
PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 336-1485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 3469 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343865600000",
"number": "1366798704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1960",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724031960",
"telephone_number": "870-336-1485",
"fax_number": "870-336-1484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 W MAIN ST",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724723114",
"telephone_number": "870-483-6131",
"fax_number": "870-483-2573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAYLOR",
"first_name": "MICHAEL",
"middle_name": "WAYNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-02",
"last_updated": "2012-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT 3469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.