Travis Maurice Radcliff

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5021808 Issued in NC

Practice address

4115 Crestwood Cir
Winston Salem, NC 27107-3788

Phone

(850) 699-3842

NPI assigned

May 20, 2020

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Lifesource of North CarolinaGroup PAC ID 7416132428, 172 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.

• Lifesource of North Carolina

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1811286156

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Psychiatry Physician
  • Huntersville, NC
  • NPI 1588387211
  NPD
• Treatment Centers LLC

  • Community/Behavioral Health Agency
  • Lexington, NC
  • NPI 1639592900
  NPD
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1518580992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 CRESTWOOD CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271073788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 CRESTWOOD CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271073788",
            "telephone_number": "850-699-3842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3545 Whitehall Park Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282734179",
            "country_code": "US",
            "telephone_number": "980-302-8850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADCLIFF",
        "first_name": "TRAVIS",
        "middle_name": "MAURICE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5021808",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021808",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NC",
            "license": "248905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Gabrial Rabinovich, MD
• Hannah McGarey Rabinovich, MD
• Madison Elizabeth Rabold
• Ashley Rabon, LCMHCA
• Jennifer Rackley, PT
• Jennifer Rader
• Radiant and Rooted Therapy PLLC
• Smiljka Radoja Ponjavic, MD
• Dmitri Raetki-Solntev
• Rafael Rivera, Jr., DDS, PLLC

• Psychiatric/Mental Health Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.