Individual provider Active NPI

Travis Fawver, DO

  • Emergency Medicine Physician
  • Newport, TN
National Provider Identifier
1467490805
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1710 Issued in TN
Practice address
435 2ND St
Newport, TN 37821-3703
Phone
(423) 625-2200
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1710 TN Primary

Addresses

Primary practice location

435 2ND St
Newport, TN 37821-3703

Mailing address

PO Box 636019
Cincinnati, OH 45263-6019
Phone (865) 985-7234

Other identifiers 3

IdentifierTypeStateIssuer
P00310644OtherTNRAILROAD MEDICARE
3319552MedicaidTN
4113345OtherTNBCBS OF TN

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20051024000063 TN Practitioner - Emergency MedicinePractitioner - Family Practice 4385660984 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Putnam Emergency Physicians PLLCGroup PAC ID 3779946488, 34 clinicians
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Eagle Creek Emergency Group, PCGroup PAC ID 2466714571, 21 clinicians
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

1850 Old Knoxville Rd
Tazewell, TN 37879-3625
Phone (423) 626-4211

301 Tyson Ave
Paris, TN 38242-4544
Phone (731) 642-1220

355 New Shackle Island Rd
Hendersonville Medical Center
Hendersonville, TN 37075-2479
Phone (615) 338-1000

7565 Dannaher Dr
Powell, TN 37849-4029
Phone (865) 859-8000

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1710TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2008 Accepting new patients
Theoria Medical CurrentSince Oct 31, 2022 Accepting new patients
East Tennessee Medical Group, PC Past Accepting new patients
Jellico Emergency Physicians Medical Group PC Emergency Medicine Past Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151

188 Hospital Ln
Jellico, TN 37762
Phone (423) 784-1272

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

1 Veterans Way
Knoxville, TN 37931
Phone (855) 240-2530

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

Interoperability endpoints

  • Direct secure messaging: tfawver@yourcarecommunity.org

Organizations & group practices 9

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1467490805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636019",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636019",
            "telephone_number": "865-985-7234",
            "fax_number": "865-985-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 2ND ST",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213703",
            "telephone_number": "423-625-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWVER",
        "first_name": "TRAVIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00310644",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3319552",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4113345",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, TN

Sources for this page

Verify at the official NPI Registry.