Individual provider Active NPI

Travis Whitmore Defreese, MD

  • Anesthesiology Physician
  • Birmingham, AL
National Provider Identifier
1477538528
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
H00727 Issued in AL
Practice address
1600 7TH Ave S
Birmingham, AL 35233-1711
Phone
(205) 939-9235
Fax
(205) 939-9936
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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 1

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

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Alabama School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Anesthesia Associates PC 16 clinicians

Practice addresses (Care Compare)

1600 7TH Ave S
Lowder 420
Birmingham, AL 35233-1711
Phone (205) 939-9235

Hospital & facility affiliations

  • The Children'S Hospital of Alabama Hospital, Birmingham, AL, CCN 013300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20101025000727 AL Practitioner - AnesthesiologyPractitioner - Pain Management 2466645205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H00727ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesia Associates PC Anesthesiology CurrentSince Jul 1, 2003 Accepting new patients

Locations

1600 7th Ave S
#420888888888888888888888888888888
Birmingham, AL 35233

1940 Elmer J Bissell Rd
Birmingham, AL 35243
Phone (205) 638-4949

1600 7th Ave S
#420
Birmingham, AL 35233
Phone (205) 638-9235

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X H00727 AL Primary

Addresses

Primary practice location

1600 7TH Ave S
Birmingham, AL 35233-1711

Mailing address

1600 7TH Ave S
Birmingham, AL 35233-1711
Phone (205) 939-9235

Other identifiers 2

IdentifierTypeStateIssuer
051515049MedicaidAL
051515049OtherALBLUE CROSS BLUESHIELD

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1477538528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9235",
            "fax_number": "205-939-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9235",
            "fax_number": "205-939-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFREESE",
        "first_name": "TRAVIS",
        "middle_name": "WHITMORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "H00727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051515049",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD",
            "identifier": "051515049",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.