Active NPI
Travis Jason Prentice
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1730935446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 163137
- Practice address
- 159 Saint Matthews Ave
Louisville, KY 40207-3137 - Phone
- (502) 899-7105
- NPI assigned
- Apr 24, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 163137 | KY | Primary |
Addresses
Primary practice location
159 Saint Matthews Ave
Louisville, KY 40207-3137
Mailing address
6803 Fegenbush LN
Louisville, KY 40228-1371
Phone (502) 744-7029
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163137 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713916800000",
"number": "1730935446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6803 FEGENBUSH LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402281371",
"telephone_number": "502-744-7029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 SAINT MATTHEWS AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402073137",
"telephone_number": "502-899-7105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTICE",
"first_name": "TRAVIS",
"middle_name": "JASON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-24",
"last_updated": "2024-04-24",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "163137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
- Premise Health of West Virginia Medical Medical Corporation
- Premise Health of West Virginia Medical, Medical Corporation
- Premise Health of West Virginia Medical, Medical Corporation
- Prencare of Kentucky, Inc
- Shavon Prentice, APRN
- Presbyterian Homes and Services of Kentucky, Inc
- Presbyterian Homes and Services of Kentucky, Inc
- Prescient Medicine Holdings, Inc.
- Prescott Plastic Surgery & Med Spa PLLC
- Angela Te-Fang Prescott, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.