Travis Jordan Sulfridge, DVM

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

247244 Issued in KY

Practice address

319 Tackett Creek Rd
Williamsburg, KY 40769-9754

Phone

(606) 549-5444

NPI assigned

Apr 24, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619222400000",
    "number": "1518549062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407690508",
            "telephone_number": "606-549-5444",
            "fax_number": "606-549-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 TACKETT CREEK RD",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407699754",
            "telephone_number": "606-549-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULFRIDGE",
        "first_name": "TRAVIS",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-24",
        "last_updated": "2021-04-24",
        "certification_date": "2021-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "247244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://outlook.office.com/owa/?path=/mail/inbox",
            "affiliation": "N",
            "address_1": "319 Tackett Creek Rd",
            "city": "Williamsburg",
            "state": "KY",
            "country_code": "US",
            "postal_code": "407699754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Williamsburg, KY
• Providers in Williamsburg, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; 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.