Active NPI
Amber Rae Teague Travis, M.ED., BCBA
- Behavior Analyst
- Greenville, SC
National Provider Identifier
1396131744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11518217
- Practice address
- 6 Pelham Ridge Dr
Greenville, SC 29615-5935 - Phone
- (803) 530-0674
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11518217 | SC | Primary |
Addresses
Primary practice location
6 Pelham Ridge Dr
Greenville, SC 29615-5935
Mailing address
6 Pelham Ridge Dr
Greenville, SC 29615-5935
Phone (803) 530-0674
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)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11518217 | SC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466121600000",
"number": "1396131744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 PELHAM RIDGE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155935",
"telephone_number": "803-530-0674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 PELHAM RIDGE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155935",
"telephone_number": "803-530-0674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "AMBER",
"middle_name": "RAE TEAGUE",
"name_prefix": "Mrs.",
"credential": "M.ED., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2016-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "SC",
"license": "11518217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.