Travis Obery Landry, D.O.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

DR.0053063 Issued in CO

Practice address

2624 Q Street, BLDG 851, Area B
Wright Patterson Afb, OH 45433

Phone

(937) 938-3894

NPI assigned

Jan 21, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1669743712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88TH MEDICAL GROUP",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-938-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 Q STREET, BLDG 851, AREA B",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-938-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "TRAVIS",
        "middle_name": "OBERY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-21",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0053063",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CO",
            "license": "DR.0053063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Elaine Krunnfusz, PHD
• Joseph Maurice Kuebker, M.D.
• Timothy James Kuehl, D.C.
• Christian Charles Lamb
• Amy Lamont, RT
• Jennifer Lynne Landucci, M.D.
• Rian Michael Laub, M.D.
• Syreeta D Lawrence, O.D
• Maximilian Samuel Lee, MD
• Karen Lewis, RTT

• Preventive Medicine/Occupational Environmental Medicine Physician in Wright Patterson Afb, OH
• Providers in Wright Patterson Afb, OH by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.