Travis James, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

11293840-1204 Issued in UT

Practice address

169 N Gateway Dr Ste 100
Providence, UT 84332-9860

Phone

(435) 554-1182

Fax

(435) 554-1950

NPI assigned

Jul 11, 2012

Last updated

May 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 UT

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

Specialty

Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00355

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Dermatology LLC

  dba Providence Dermatology

  • Dermatology Physician
  • Providence, UT
  • NPI 1568029957
  Medicare reassignment NPD Authorized official

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

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1477818920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR STE 100",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329860",
            "telephone_number": "435-752-5741",
            "fax_number": "435-752-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR STE 100",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329860",
            "telephone_number": "435-554-1182",
            "fax_number": "435-554-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 Medical Dr Ste 311",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843023284",
            "country_code": "US",
            "telephone_number": "435-554-1182",
            "fax_number": "435-554-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "OP 60613648",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "O-0902",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "11293840-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Pain Center and Anesthesia PC (Raymond L. Bedell, DO)
• Integrity Chiropractic
• Intermountain Spine and Pain Center
• Interwest Anesthesia Associates LLC
• James Dennis Mathews, D.O., P.C.
• Jordyn Jay, RBT
• Dylan Wyatt Jensen, RBT
• Wylee Kyle Jensen, APRN, FNP-C
• Jess Henry Jewett, M.D.
• JHJ Wound Care PLLC

• Dermatology Physician in Providence, UT
• Providers in Providence, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.