Travis O Ellis

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

64717 Issued in WV

Practice address

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Phone

(304) 388-5503

NPI assigned

May 19, 2020

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

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Logan Regional Anesthesia Services, LLCGroup PAC ID 4183097892, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Logan Regional Medical Center Hospital, Logan, WV, CCN 510048

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Logan Regional Anesthesia Services, LLC

  • Anesthesiology Physician
  • Logan, WV
  • NPI 1033838727
  Medicare reassignment Care Compare group
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Charleston Area Medical Center, Inc.

  • Rural Health Clinic/Center
  • Summersville, WV
  • NPI 1518579689
  NPD (past)
• Charleston Area Medical Center, Inc.

  • Hospitalist Physician
  • Ronceverte, WV
  • NPI 1972125995
  NPD (past)

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

• Logan General Hospital LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Logan, WV
  • NPI 1295789675
  Care Compare affiliation
• Logan General Hospital LLC

  • General Acute Care Hospital
  • Logan, WV
  • NPI 1750332565
  Care Compare affiliation

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1598388043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TRAVIS",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "64717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Killian Ellis, PA-C
• Kristina Ellis
• Laura Jean Ellis, MS, CCC-SLP
• Lisa Ellis
• Quentia Ellis
• Tyara Ellis
• Victoria Rose Ellis, RBT
• Amy Ellison, PT
• Jeremiah Ellison
• John Ellithorp

• Certified Registered Nurse Anesthetist in Charleston, WV
• Providers in Charleston, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.