Individual provider Active NPI

Andrew Christian Traver, DPT, MBA

  • Physical Therapist
  • Stevensville, MT
National Provider Identifier
1619615275
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
420 Main St
Stevensville, MT 59870-2503
Phone
(406) 777-5354
NPI assigned
May 24, 2022
Last updated
May 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MT Primary

Addresses

Primary practice location

420 Main St
Stevensville, MT 59870-2503

Mailing address

4847 Sonoma St
Missoula, MT 59808-8690
Phone (415) 717-3459

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220610002628 MT Practitioner - Physical Therapist in Private Practice 1658759170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sapphire Physical Therapy PCGroup PAC ID 8123099603, 5 clinicians

Practice addresses (Care Compare)

1705 Bow St
Missoula, MT 59801-5652
Phone (406) 549-5283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Sapphire Physical Therapy, PC Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Corvallis Physical Therapy, PC Single Specialty CurrentSince May 29, 2022 Accepting new patients

Locations

336 Fairgrounds Rd
Hamilton, MT 59840
Phone (406) 375-0980

1705 Bow St
Missoula, MT 59801
Phone (406) 219-1407

Organizations & group practices 2

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": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1619615275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 SONOMA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598088690",
            "telephone_number": "415-717-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MAIN ST",
            "city": "STEVENSVILLE",
            "state": "MT",
            "postal_code": "598702503",
            "telephone_number": "406-777-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVER",
        "first_name": "ANDREW",
        "middle_name": "CHRISTIAN",
        "credential": "DPT, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.