Active NPI
Travis D Hubin, DO
- Family Medicine Physician
- Wichita, KS
National Provider Identifier
1679556955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0527820
- Practice address
- 13213 W 21St St N
Wichita, KS 67235-9625 - Phone
- (316) 945-0142
- NPI assigned
- Nov 21, 2005
- Last updated
- Jan 16, 2014
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0527820 | KS | Primary |
Addresses
Primary practice location
13213 W 21St St N
Wichita, KS 67235-9625
Mailing address
13213 W 21St St N
Wichita, KS 67235-9625
Phone (316) 945-0142
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100330010L | Medicaid | KS |
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0527820 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sumner Community Hospital LLC | Family Medicine | Current | Accepting new patients |
| Emergency Services of Kansas, PA | Family Medicine | Past | Accepting new patients |
| Kansas Imaging Consultants, PA | Past | Accepting new patients |
Organizations & group practices 3
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.
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-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1679556955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13213 W 21ST ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672359625",
"telephone_number": "316-945-0142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13213 W 21ST ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672359625",
"telephone_number": "316-945-0142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBIN",
"first_name": "TRAVIS",
"middle_name": "D",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "0527820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100330010L",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.