Jessica Ruth Travis, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN1039813 Issued in DC

Practice address

111 Michigan Ave NW
Washington, DC 20010-2916

Phone

(202) 476-3517

Fax

(202) 476-2490

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica Ruth Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, 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 and National Provider Directory roles.

• Children'S Hospital

  • Pediatrics Physician
  • Washington, DC
  • NPI 1780800128
  NPD
• Children'S Hospital

  • Children's Hospital
  • Washington, DC
  • NPI 1912939703
  NPD
• Children'S Hospital

  • Community/Retail Pharmacy
  • Silver Spring, MD
  • NPI 1326878349
  NPD
• Pediatric Partners of Stafford PC

  • Pediatrics Physician
  • Stafford, VA
  • NPI 1457381766
  NPD (past)

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1417318155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 1/2 6TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032706",
            "telephone_number": "201-835-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-3517",
            "fax_number": "202-476-2490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Soaring Eagle Dr",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225563903",
            "country_code": "US",
            "telephone_number": "540-720-2126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "JESSICA",
        "middle_name": "RUTH",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024173380",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN1039813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "JOHNSON",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Taryn Elise Travis, MD
• J Braden Amadeus Traw
• India Leshay Traynham
• TRC - Georgetown Regional Dialysis LLC
• TRC - Georgetown Regional Dialysis LLC

• Pediatric Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Pediatric Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.