Travis a. Gresham, III, O.D.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

OPC1224 Issued in FL

Legal business name

TRAVIS A. GRESHAM, III, O.D.

Practice address

25225 Chamber of Commerce Dr
Bonita Springs, FL 34135-7887

Phone

(239) 495-2020

Fax

(239) 947-2020

NPI assigned

Feb 5, 2016

Last updated

Feb 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Travis A Gresham III, O.D.NPI 1861591349

Title

Owner

Phone

(239) 495-2020

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Travis A Gresham III, O.D.

  • Optometrist
  • Bonita Springs, FL
  • NPI 1861591349
  NPD (past) Authorized official

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1720446792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25225 CHAMBER OF COMMERCE DR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341357887",
            "telephone_number": "239-495-2020",
            "fax_number": "239-947-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25225 CHAMBER OF COMMERCE DR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341357887",
            "telephone_number": "239-495-2020",
            "fax_number": "239-947-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS A. GRESHAM, III, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-495-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "OPC1224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Towncare Dental of Bonita Springs, PA (Main Street Children's Dentistry of Bonita Springs)
• Trae M Sinn PA
• Trails Edge Surgery Center, LLC
• Trans World Therapy, LLC (Trans World Therapy)
• Karen Traugh, DPT
• Treehouse Dental Care (Treehouse Children's Dentistry)
• Treehouse Dental Care, PA (Treehouse Childrens Dentistry)
• Triana Internal Medicine, LLC
• Jason Triana, M.D.
• Trikala Laboratories a LLC

• Health Service Clinic/Center in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.