NPIMap

Individual provider Active NPI

Eric Traviss

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1568875102
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP000858 Issued in SD
Practice address
1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651
Phone
(605) 328-2663
Fax
(605) 328-3760
NPI assigned
Jun 10, 2014
Last updated
Jul 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000858 SD Primary
Family Nurse Practitioner 363LF0000X CP000858 SD

Addresses

Primary practice location

1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140813002931 SD Practitioner - Nurse Practitioner 0345467445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists CharteredGroup PAC ID 9234031329, 47 clinicians

Practice addresses (Care Compare)

201 W 69TH St
Sioux Falls, SD 57108-2403
Phone (605) 336-0635

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Dec 7, 2019 Accepting new patients
Avera McKennan Current Accepting new patients
Urology Specialists Chartered CurrentSince Sep 7, 2021 Accepting new patients

Locations

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

201 W 69th St
Sioux Falls, SD 57108
Phone (605) 336-0635

910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098

Interoperability endpoints

  • Direct secure messaging: eric.traviss.p1@direct.urologyspecialists.nextgenshare.com
  • Direct secure messaging: eric.traviss@avera.sdhealthlink.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1568875102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663",
            "fax_number": "605-328-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVISS",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000858",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.