Individual provider Active NPI

Michelle Ann Travis, FNP-BC

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1447560644
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NPP37467 Issued in RI
Practice address
2 Dudley St
Suite 174-185
Providence, RI 02905-3236
Phone
(401) 421-0710
Fax
(401) 421-0796
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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 NPP37467 RI Primary

Addresses

Primary practice location

2 Dudley St
Suite 174-185
Providence, RI 02905-3236

Mailing address

2 Dudley St
Suite 174-185
Providence, RI 02905-3236
Phone (401) 421-0710

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NPP37467RIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1447560644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 174-185",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-421-0710",
            "fax_number": "401-421-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 174-185",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-421-0710",
            "fax_number": "401-421-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "NPP37467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.