Travis Reid Edwards, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160584184 Issued in WA

Practice address

1455 NE Colorado St
Pullman, WA 99163

Phone

(509) 335-0238

NPI assigned

May 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1649706185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641602",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991641602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NE COLORADO ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "99163",
            "telephone_number": "509-335-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TRAVIS",
        "middle_name": "REID",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160584184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "200014856",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINERS' ASSOCIATION",
            "identifier": "63370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH, LICENSED ATHLETIC TRAINER",
            "identifier": "A160584184",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshall Dumas, OTR
• Mary F Eagen-Poch, L.M.P.
• Ed and Beatriz Schweitzer Autism Center, LLC
• Collette Dilworth Edge, MOT
• William Ora Edwards III, PHARMD
• Edwin M. Tingstad, MD PLLC
• Jill Elbracht, NP
• Taylor Ellsworth, MSW
• Carlene L Emerson, PHARMD
• Richard A Emtman, MD

• Athletic Trainer in Pullman, WA
• Providers in Pullman, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.