Individual provider Active NPI

Travis Pace, D.P.T.

  • Physical Therapist
  • Hazlehurst, MS
National Provider Identifier
1700283223
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5366 Issued in MS
Practice address
236 Caldwell Dr
Hazlehurst, MS 39083-2723
Phone
(601) 894-9004
NPI assigned
Nov 26, 2014
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5366 MS Primary

Addresses

Primary practice location

236 Caldwell Dr
Hazlehurst, MS 39083-2723

Mailing address

2416 Highway 45 N
Columbus, MS 39705-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150219001137 MS Practitioner - Physical Therapist in Private Practice 9032434808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

117 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone (601) 892-6330

703 Clinton Pkwy
Clinton, MS 39056-5245
Phone (601) 708-4205

725 Clinton Pkwy
Clinton, MS 39056-5245
Phone (601) 707-8666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Jan 30, 2017 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Jan 30, 2017 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Jan 30, 2017 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2015 Highpointe Dr
Brandon, MS 39042
Phone (601) 724-7310

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

950 E County Line Rd
Ste D
Ridgeland, MS 39157
Phone (601) 899-0002

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

Organizations & group practices 5

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": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1700283223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 HIGHWAY 45 N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 CALDWELL DR",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832723",
            "telephone_number": "601-894-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "TRAVIS",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-26",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.