Travis C Konzelman, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN199709 Issued in GA

Practice address

1350 Walton Way
Augusta, GA 30901

Phone

(706) 722-9011

NPI assigned

Feb 16, 2015

Last updated

Aug 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Em-I Medical Services. LLC

  • Nurse Practitioner
  • Bremen, GA
  • NPI 1851569560
  Medicare reassignment NPD
• Med Now Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Evans, GA
  • NPI 1245475771
  Medicare reassignment NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005
  NPD
• Georgia Em-I Medical Services, PC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1952673006

  Nurse Practitioner

  NPD
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1407247158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 RIVERSIDE DR",
            "address_2": "STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "706-722-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZELMAN",
        "first_name": "TRAVIS",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN199709",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN199709",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN199709",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "GA",
            "license": "RN199709",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "RN199709",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Wynn Kogel, MD
• Ravindra Kolhe, M.D.PH.D
• Linda A Kolmar, PAC
• Dileep R Kondur, DMD, MS
• Feng-Ming Phoenix Kong, MD
• Amanda Korby, MA, LPC, CFRS
• Donald Jeffrey Korkis, M.D.
• Rawan Korman, MD
• Tabitha F Korona, PT, DPT
• Joseph John Korwin, M.D.

• Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.