Individual provider Active NPI

Travis Pelley, FNP-C

  • Family Nurse Practitioner
  • Brenham, TX
National Provider Identifier
1437836376
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1127456 Issued in TX
Practice address
9290 Lueckemeyer Rd
Brenham, TX 77833-6795
Phone
(281) 620-2873
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1127456 TX Primary

Addresses

Primary practice location

9290 Lueckemeyer Rd
Brenham, TX 77833-6795

Mailing address

9290 Lueckemeyer Rd
Brenham, TX 77833-6795
Phone (281) 620-2873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20231020003119 TX Practitioner - Nurse Practitioner 8628424058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

1115 E Tyler St
Integrity Urgent Care
Athens, TX 75751-2145
Phone (903) 292-5015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1127456TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Oct 1, 2023 Accepting new patients
Emergency Medicine Services of TX, PLLC CurrentSince Oct 1, 2023 Accepting new patients
DCS Medical PA CurrentSince Oct 1, 2023 Accepting new patients

Locations

1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015

2608 Highway 36 S
Brenham, TX 77833
Phone (979) 451-6000

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

2901 W 7th Ave
Corsicana, TX 75110
Phone (903) 616-0111

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1437836376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9290 LUECKEMEYER RD",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778336795",
            "telephone_number": "281-620-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 LUECKEMEYER RD",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778336795",
            "telephone_number": "281-620-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEY",
        "first_name": "TRAVIS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1127456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.