Travis Wound Clinic

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

TRAVIS WOUND CLINIC

Practice address

99 John Travis Rd
Poplarville, MS 39470-7419

Phone

(404) 368-4140

Fax

(404) 368-4140

NPI assigned

Sep 23, 2025

Last updated

Sep 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Consuela Y Travis, CERTIFIED WOUND CARE

Title

Owner

Phone

(404) 368-4140

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1427920990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JOHN TRAVIS RD",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394707419",
            "telephone_number": "404-368-4140",
            "fax_number": "404-368-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 JOHN TRAVIS RD",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394707419",
            "telephone_number": "404-368-4140",
            "fax_number": "404-368-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS WOUND CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "CONSUELA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-368-4140",
        "authorized_official_credential": "CERTIFIED WOUND CARE"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin David Southern-Bruno, LMSW
• Lindsey La'Ray Steele, LPTA
• Stone County Hospital, Inc.
• Amber Rikia Tillman
• Anton S Tran, PHARMD.
• Brittney Roberts Tynes, PT
• Whitney S Walker, OT
• Alicia Lachelle Wallace Stevens, M.D.
• Daphne Watts
• Kalena R Wells, D.C.

• Geriatric Medicine (Family Medicine) Physician in Poplarville, MS
• Providers in Poplarville, MS by specialty
• Geriatric Medicine (Family Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.