Travis L Dessoffy, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

CPO02116 Issued in NC

Practice address

1025 WH Smith Blvd Ste 108
Greenville, NC 27834-5278

Phone

(252) 215-2215

NPI assigned

Mar 30, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Absolute Orthotics and Prosthetics

  • Prosthetic/Orthotic Supplier
  • Fayetteville, NC
  • NPI 1861146862
  NPD Authorized official
• Advanced Brace & Limb

  • Prosthetic/Orthotic Supplier
  • Fayetteville, NC
  • NPI 1689992851

  Orthotist

  NPD (past)
• Orthotics & Prosthetics East Inc

  • Customized Equipment (DME)
  • Greenville, NC
  • NPI 1790736379

  Orthotist

  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1376663534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5172 US HIGHWAY 264 E",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345805",
            "telephone_number": "252-908-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 WH SMITH BLVD STE 108",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345278",
            "telephone_number": "252-215-2215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Kandemor Ln",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278043212",
            "country_code": "US",
            "telephone_number": "252-443-5116",
            "fax_number": "252-443-5347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4140 Ferncreek Dr Ste 803",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "28314",
            "country_code": "US",
            "telephone_number": "910-483-5737",
            "fax_number": "910-483-2327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESSOFFY",
        "first_name": "TRAVIS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NC",
            "license": "CPO02116",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NC",
            "license": "CPO02116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376663534",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetist in Greenville, NC
• Providers in Greenville, NC by specialty
• Prosthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.