Active NPI
Blake Travers
- Student in an Organized Health Care Education/Training Program
- Jackson, TN
National Provider Identifier
1629998232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- I17135
- Practice address
- 1050 Union University Dr
Jackson, TN 38305-3697 - Phone
- (270) 508-0552
- NPI assigned
- Jul 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | I17135 | KY | Primary |
Addresses
Primary practice location
1050 Union University Dr
Jackson, TN 38305-3697
Mailing address
1027 US Highway 60 W
Smithland, KY 42081-8942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1629998232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1027 US HIGHWAY 60 W",
"city": "SMITHLAND",
"state": "KY",
"postal_code": "420818942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 UNION UNIVERSITY DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053697",
"telephone_number": "270-508-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVERS",
"first_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-07-16",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "KY",
"license": "I17135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
- Tracy A Townes Bougard, M.D.
- Floyd Goza Trammell Jr., D.D.S.
- Transsouth Health Care PLLC
- Stephanie Gwynn Tranum, MSW
- Mark William Traugh, P.A.
- Laura Christine Treadway, SP
- Noreen M Trefz, LPC, MHSP
- Mary Ann Tremblay, LPC, MHSP, CEAP
- Tri State Muller Optical Inc
- Tri-County Home Health and Hospice, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.