Travis Dudley, MSOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT21664 Issued in CA

Practice address

162 S Main St
Bishop, CA 93514-3415

Phone

(760) 872-2942

NPI assigned

Feb 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Mono Health Care DistrictGroup PAC ID 9830002401, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Southern Mono Health Care District

  • Critical Access Hospital Clinic/Center
  • Mammoth Lakes, CA
  • NPI 1962444059
  Medicare reassignment Care Compare group NPD
• Southern Mono Healthcare District

  • Rehabilitation Clinic/Center
  • Bishop, CA
  • NPI 1518460070
  NPD (past)

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1487246559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 W LINE ST UNIT 491",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935157032",
            "telephone_number": "858-248-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 S MAIN ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143415",
            "telephone_number": "760-872-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Sierra Park Rd",
            "address_purpose": "LOCATION",
            "city": "Mammoth Lakes",
            "state": "CA",
            "postal_code": "935462073",
            "country_code": "US",
            "telephone_number": "760-934-7302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "TRAVIS",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT21664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mahotdudley@mammothhospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Mammoth Hospital Direct Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "162 S Main St",
            "city": "Bishop",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935143415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Downard
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• DRS. Kamei and Hathaway
• Lauren Dudley
• Henry Humbert Duke Jr., M.D.
• Ariel Duvall, PT, DPT
• Matthew Walden Earhart, O.D., MED.
• Eastern Sierra Emergency Physicians, a Medical Partnership
• Eastern Sierra Nutrition and Lactation LLC

• Occupational Therapist in Bishop, CA
• Providers in Bishop, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.