Individual provider Active NPI

Travis Wayne Henson, M.D

  • Emergency Medicine Physician
  • Apple Valley, CA
National Provider Identifier
1548205560
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A85711 Issued in CA
Practice address
18300 Highway 18
Apple Valley, CA 92307
Phone
(760) 242-2311
NPI assigned
Jun 17, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A85711 CA Primary

Addresses

Primary practice location

18300 Highway 18
Apple Valley, CA 92307

Mailing address

2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00A857110MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000981 CA Practitioner - Emergency Medicine 6800878331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2004 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2004 Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 3

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1548205560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307",
            "telephone_number": "760-242-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "TRAVIS",
        "middle_name": "WAYNE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A85711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A857110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.