Travis Todd McKenzie, D.O.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

10246349-1204 Issued in UT

Practice address

4401 Harrison Blvd
Ogden, UT 84403

Phone

(801) 387-2800

NPI assigned

Apr 2, 2012

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

Enrolled in UT, ID, WA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tellica Imaging - Washington LLCGroup PAC ID 0648757393, 50 clinicians

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Tellica Imaging - Washington LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1346093150
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Family Medicine

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Mountain Medical Physician Specialists PC

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1720035520

  Body Imaging

  Medicare reassignment NPD
• Tellica Imaging, LLC

  • Radiology Clinic/Center
  • Boise, ID
  • NPI 1760197198

  Diagnostic Radiology, UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Neurological Surgery Physician
  • St George, UT
  • NPI 1649413303
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1699909457
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services, Inc.

  • Physiological Laboratory
  • Cedar City, UT
  • NPI 1538841747
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Ogden, UT
  • NPI 1144802802
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • West Valley City, UT
  • NPI 1407438039
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Spanish Fork, UT
  • NPI 1518727734
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1386900595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-313-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84403",
            "telephone_number": "801-387-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "801-641-8842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841075701",
            "country_code": "US",
            "telephone_number": "801-507-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8th Ave & C Street",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841434973",
            "country_code": "US",
            "telephone_number": "801-408-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "TRAVIS",
        "middle_name": "TODD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "10246349-1204",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "10246349-1204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savanah McKay
• Scott B McKay, PA-C
• Mandy McKean
• David Michael McKellar, DDS
• Sienna Marci McKenzie
• Heather McKinnon, CSW
• Madison Leslie McKinnon, RN
• Mallory McKnight, CMHC
• Sierra Kathleen McLain, LCSW, MSW
• Claire Kathleen McMahon, M.D, F.A.A.P., FACC

• Vascular & Interventional Radiology Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Vascular & Interventional Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.