Travis Dean Smith

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

00067774 Issued in TN

Practice address

443 Grover LN
Jamestown, TN 38556-5568

Phone

(931) 239-2495

Fax

(931) 879-2788

NPI assigned

Aug 13, 2018

Last updated

Aug 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1467931287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 GROVER LN",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385565568",
            "telephone_number": "931-239-2495",
            "fax_number": "931-879-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 GROVER LN",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385565568",
            "telephone_number": "931-239-2495",
            "fax_number": "931-879-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRAVIS",
        "middle_name": "DEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "TN",
            "license": "00067774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sisco Family Dentistry (Jamestown Family Dentistry)
• Jennifer Smith
• Jordan D Smith, O.D.
• Kelvin Russell Smith II, PT, DPT
• Misty Dawn Smith
• State of Tennessee (Fentress County Health Department)
• Summit Medical Group, PLLC (Sewell Family Practice, a division of Summit Medical Group)
• Support Private Duty Care
• Support Private Duty Care
• Whitney Nicole Thomas

• Home Modifications Contractor in Jamestown, TN
• Providers in Jamestown, TN by specialty
• Home Modifications Contractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.