Individual provider Active NPI

Travis W Davis, MD

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1669590477
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME168377 Issued in FL
Practice address
503 Cagan View Rd Ste 100
Clermont, FL 34714-6468
Phone
(407) 905-6014
Fax
(407) 654-4113
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL27933 SC
Family Medicine Physician 207Q00000X 27933 SC
Internal Medicine Physician 207R00000X ME168377 FL Primary

Addresses

Primary practice location

503 Cagan View Rd Ste 100
Clermont, FL 34714-6468

Mailing address

503 Cagan View Rd Ste 100
Clermont, FL 34714-6468
Phone (407) 905-6014

Other practice location 1

105 Liberty Blvd
Liberty, SC 29657-1641
Phone (864) 843-9213

Other identifiers 1

IdentifierTypeStateIssuer
GP2510MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080811000175 SC Practitioner - Family Practice 9739253642 Reassigns benefits to 3 organizations
I20240717004829 FL Practitioner - Internal Medicine 9739253642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600

Hospital & facility affiliations

  • Mederi Caretenders Home health agency, Clermont, FL, CCN 107470
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL27933SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Memorial Hospital CurrentSince Jul 28, 2008 Accepting new patients
Cannon Memorial Hospital Family Medicine Current Accepting new patients
Cannon Memorial Hospital CurrentSince Jul 28, 2008 Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Cannon Memorial Hospital Family Medicine CurrentSince Jul 28, 2008 Accepting new patients
Cannon Memorial Hospital CurrentSince Jul 28, 2008 Accepting new patients

Locations

503 Cagan View Rd
Ste 100
Clermont, FL 34714
Phone (407) 635-5800

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

111 W Roper Rd
Easley, SC 29640
Phone (864) 897-8280

105 Liberty Blvd
Liberty, SC 29657
Phone (864) 843-8500

123 Wg Acker Dr
Pickens, SC 29671
Phone (864) 512-2465

123 Wg Acker Dr
Ste B
Pickens, SC 29671
Phone (864) 878-2435

Interoperability endpoints

  • Direct secure messaging: tdavis45385@direct.anmedhealth.net

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1669590477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CAGAN VIEW RD STE 100",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347146468",
            "telephone_number": "407-905-6014",
            "fax_number": "407-654-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CAGAN VIEW RD STE 100",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347146468",
            "telephone_number": "407-905-6014",
            "fax_number": "407-654-4113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Liberty Blvd",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "SC",
            "postal_code": "296571641",
            "country_code": "US",
            "telephone_number": "864-843-9213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TRAVIS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL27933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME168377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2510",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.