Tyson Kelly Travis, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2019035084 Issued in MO

Practice address

2820 E Rock Haven Rd Ste 120
Harrisonville, MO 64701-4413

Phone

(816) 380-7662

NPI assigned

Apr 29, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Bates County Memorial Hospital

  • Surgery Physician
  • Butler, MO
  • NPI 1740311471
  Medicare reassignment NPD
• Bates County Memorial Hospital

  • Rural Health Clinic/Center
  • Rich Hill, MO
  • NPI 1477009959
  NPD
• Bates County Memorial Hospital

  • General Acute Care Hospital
  • Butler, MO
  • NPI 1770536740
  NPD
• Mawd Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lenexa, KS
  • NPI 1376209130
  NPD
• Mawd Pathology Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Lenexa, KS
  • NPI 1033108519
  NPD

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1447660451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21200 S STATE ROUTE Y",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640129101",
            "telephone_number": "816-738-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 E ROCK HAVEN RD STE 120",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014413",
            "telephone_number": "816-380-7662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6950 E Chauncey Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850545179",
            "country_code": "US",
            "telephone_number": "480-420-0749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "TYSON",
        "middle_name": "KELLY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "DO192433",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "SL1000",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2019035084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Theiss, PHARMD
• Thrive Through Change Counseling LLC
• Lon Roland Tracy, DDS
• Aaron L. Travis, D.O.
• Damon K. Travis, D.O.
• Rebecca Troup
• Molly Rae Urton, FNP
• Justin Connor Vann, PT, DPT
• Venalink Diagnostics LLC
• Vetlife Senior Care

• Orthopaedic Surgery Physician in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.