Individual provider Active NPI

Travis Herald, DPT

  • Physical Therapist
  • Salem, VA
National Provider Identifier
1518449586
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212191 Issued in VA
Practice address
109 Knotbreak Rd
Salem, VA 24153-5404
Phone
(540) 772-8022
NPI assigned
Sep 5, 2018
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305212191 VA Primary

Addresses

Primary practice location

109 Knotbreak Rd
Salem, VA 24153-5404

Mailing address

4533 Brambleton Ave
Roanoke, VA 24018-3436
Phone (540) 772-8022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105000481 VA Practitioner - Physical Therapist in Private Practice 2365795663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lucas Physical Therapy IncGroup PAC ID 8123087970, 13 clinicians

Practice addresses (Care Compare)

109 Knotbreak Rd
Salem, VA 24153-5404
Phone (540) 772-8022

29 Cedar Plateau Way
Daleville, VA 24083-1119
Phone (540) 591-6060

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
71.18
Promoting interoperability
92
Improvement activities
40
Cost
79.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305212191VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucas Physical Therapy Inc Physical Therapist CurrentSince Jun 4, 2018 Accepting new patients
Greenbrier Valley Physical Therapy LLC CurrentSince Jan 31, 2022 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist Current Accepting new patients
Greenbrier Valley Physical Therapy, LLC CurrentSince Jan 31, 2022 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Past Accepting new patients
Greenbrier Valley Physical Therapy LLC Past Accepting new patients

Locations

29 Cedar Plateau Way
Daleville, VA 24083
Phone (540) 591-6060

4325 Brambleton Ave
Ste A
Roanoke, VA 24018

4533 Brambleton Ave
Roanoke, VA 24018
Phone 5407728022 ext. 5616

109 Knotbreak Rd
Salem, VA 24153

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1518449586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183436",
            "telephone_number": "540-772-8022",
            "fax_number": "540-772-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 KNOTBREAK RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535404",
            "telephone_number": "540-772-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERALD",
        "first_name": "TRAVIS",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.