Travis Nesbitt, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11234 Issued in NC

Practice address

548 Williamson Rd Ste 1
Mooresville, NC 28117-9111

Phone

(845) 943-8335

NPI assigned

Jul 6, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 14, 2020 through Jul 14, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650758400000",
    "number": "1437532736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 WILLIAMSON RD STE 1",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179111",
            "telephone_number": "845-943-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 WILLIAMSON RD STE 1",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179111",
            "telephone_number": "845-943-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBITT",
        "first_name": "TRAVIS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2022-04-24",
        "certification_date": "2022-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "11234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.