Meghan J Traverse, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA12774 Issued in FL

Practice address

687 Branch Dr
Port Orange, FL 32127-5893

Phone

(386) 682-9474

NPI assigned

Jun 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407058506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 BRANCH DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275893",
            "telephone_number": "386-682-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 BRANCH DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275893",
            "telephone_number": "386-682-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVERSE",
        "first_name": "MEGHAN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA12774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Lee Tornavacca
• Carla Torres Santiago
• Ernesto I Torres, DMD
• Total Vision of Port Orange, Inc.
• Town Center Medical Services, LLC (Advanced Family Practice and Advanced Medical Center Gastroenterology)
• Jennifer Demaisip Traverso, APRN
• Spencer Tretter
• Amanda Trieloff
• Trinity Medical Transportation
• Joshua Trinklein, OTR/L

• Physical Therapy Assistant in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.