Active NPI
Kelsey Brooke Travis, PT
- Physical Therapist
- Elk City, OK
National Provider Identifier
1407492200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4526
- Practice address
- 2301 Bell Ave
Elk City, OK 73644-2254 - Phone
- (580) 225-3335
- NPI assigned
- Nov 27, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4526 | OK | Primary |
Addresses
Primary practice location
2301 Bell Ave
Elk City, OK 73644-2254
Mailing address
2301 Bell Ave
Elk City, OK 73644-2254
Phone (580) 225-3335
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201302130A | Medicaid | OK | |
| 4526 | Other | OK | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4526 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1407492200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 BELL AVE",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736442254",
"telephone_number": "580-225-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 BELL AVE",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736442254",
"telephone_number": "580-225-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "KELSEY",
"middle_name": "BROOKE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-27",
"last_updated": "2024-11-27",
"certification_date": "2024-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4526",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201302130A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "4526",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.