Individual provider Active NPI

Travis Alan Gage, DC

  • Chiropractor
  • Vienna, VA
National Provider Identifier
1619342888
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557363 Issued in VA
Practice address
301 Maple Ave W Ste 515
Vienna, VA 22180-4302
Phone
(703) 319-1212
Fax
(703) 319-1215
NPI assigned
Dec 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557363 VA Primary

Addresses

Primary practice location

301 Maple Ave W Ste 515
Vienna, VA 22180-4302

Mailing address

301 Maple Ave W Ste 515
Vienna, VA 22180-4302
Phone (703) 319-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927002561 DC Practitioner - Chiropractic 1052616612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Rxwellness Spine and Health - Vienna LLCGroup PAC ID 0941692305, 5 clinicians

Practice addresses (Care Compare)

360 Maple Ave W
Suite B
Vienna, VA 22180-5614
Phone (703) 904-9666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104557363VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rxwellness Spine & Health - Vienna LLC Chiropractor CurrentSince Sep 1, 2023 Accepting new patients
Rxwellness Spine & Health - Tysons McLean LLC Chiropractor CurrentSince Jun 26, 2023 Accepting new patients
Dr. Brandon R. Lemuel DC,PC Chiropractor PastSince Oct 23, 2022 Accepting new patients
Jacobs Chiropractic LLC Chiropractor PastSince Mar 26, 2023 Accepting new patients

Locations

950 Herndon Pkwy
Ste 130
Herndon, VA 20170
Phone (703) 272-5402

360 Maple Ave W
Ste B
Vienna, VA 22180
Phone (434) 989-4901

8609 Westwood Center Dr
Ste 620
Vienna, VA 22182

360 Maple Ave W
Vienna, VA 22180
Phone (703) 255-3334

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1619342888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 515",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804302",
            "telephone_number": "703-319-1212",
            "fax_number": "037-319-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 515",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804302",
            "telephone_number": "703-319-1212",
            "fax_number": "703-319-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "TRAVIS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-14",
        "last_updated": "2022-10-18",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.