Travis Wayne Anschutz, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

E-11227 Issued in AR

Practice address

3000 Medical Center Pkwy
Bentonville, AR 72712-3217

Phone

(479) 553-1294

NPI assigned

Feb 2, 2007

Last updated

Sep 8, 2020By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Advanced Aesthetics & Wellness Center PA, Earlmd Family Medicine PA

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1811135809
  NPD (past)
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1497893366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY # 100",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-535-4575",
            "fax_number": "208-535-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL CENTER PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123217",
            "telephone_number": "479-553-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Channing Way # 100",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047533",
            "country_code": "US",
            "telephone_number": "208-535-4575",
            "fax_number": "208-535-4569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANSCHUTZ",
        "first_name": "TRAVIS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "39175",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "ID",
            "license": "M10102",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AR",
            "license": "E-11227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808012100",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "travis.anschutz.1@2229.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3000 Medical Center Pkwy",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727123217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Anderson, BCBA
• Melissa Dyan Anderson, PT
• Chandler Benson Long Anglin, OTR/L
• Clint Lee Anglin, ATC,LAT
• Rachel Angulo, MNSC, APRN, CPNP-PC
• Jillian Antonowicz
• Callie Antuna, OTR
• Aperture Counseling, LLC
• Jordan Philip Applegate
• Arbor Vitae Chiropractic Inc

• Neonatal-Perinatal Medicine Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Neonatal-Perinatal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.