Individual provider Active NPI

Travis Michael Bruns

  • Mental Health Counselor
  • Sidney, OH
National Provider Identifier
1679163653
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2505090 Issued in OH
Practice address
1101 N Vandemark Rd
Sidney, OH 45365-3567
Phone
(937) 622-7393
NPI assigned
Jan 22, 2021
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.2505090 OH Primary

Addresses

Primary practice location

1101 N Vandemark Rd
Sidney, OH 45365-3567

Mailing address

1011 N Vandemark Rd
Sidney, OH 45365-3567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250307003310 OH Practitioner - Mental Health Counselor 1254852171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darke County Recovery ServicesGroup PAC ID 7315176005, 18 clinicians

Practice addresses (Care Compare)

1101 N Vandemark Rd
Sidney, OH 45365-3567
Phone (937) 548-6842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Darke County Recovery Services CurrentSince Feb 13, 2025 Accepting new patients

Locations

212 E Main St
Greenville, OH 45331
Phone (937) 423-6344

600 Walnut St
Greenville, OH 45331
Phone (937) 335-0361

1101 N Vandemark Rd
Sidney, OH 45365
Phone (937) 492-8080

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/recoveryandwellnessohio/r4/

Organizations & group practices 1

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1679163653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N VANDEMARK RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453653567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N VANDEMARK RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453653567",
            "telephone_number": "937-622-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "TRAVIS",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-22",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2505090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.