Portia F Travis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R800172 Issued in MS

Practice address

206 Longwood Dr
Clinton, MS 39056-5436

Phone

(601) 214-2045

NPI assigned

Dec 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brentwood Acquisition Inc

  • Psychiatric Hospital
  • Flowood, MS
  • NPI 1487638441
  Medicare reassignment NPD
• Peace Children's Clinic

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1891975603
  NPD (past)

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1710161708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514H E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-713-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 LONGWOOD DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565436",
            "telephone_number": "601-214-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "PORTIA",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R800172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Cannon Stewart, OD, PLLC
• Michael Dillon Toth
• Erica Yolonda Marie Towers, P-LPC
• Richard Ryan Tracy, D.M.D.
• Tranquil Blessings Hospice, Inc.
• Trinity Mission Health & Rehab of Clinton, LLC
• Jennifer Reed Tuccio, NP
• Sophila Tucker
• Turnage Family Dentistry, PLLC
• April Anders Turnage, D.M.D.

• Family Nurse Practitioner in Clinton, MS
• Providers in Clinton, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.