Active NPI
Amanda Rose Travis, LCSW
- Clinical Social Worker
- Killeen, TX
National Provider Identifier
1770724155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 67671
- Practice address
- 2206 E Central Texas Expy
Killeen, TX 76543-5315 - Phone
- (254) 519-4162
- Fax
- (254) 519-3464
- NPI assigned
- Mar 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-06248 | NM | |
| Clinical Social Worker | 1041C0700X | 67671 | TX | Primary |
Addresses
Primary practice location
2206 E Central Texas Expy
Killeen, TX 76543-5315
Mailing address
2163 Bowles RNCH
Belton, TX 76513-5866
Phone (575) 635-8947
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80137857 | Medicaid | NM |
Other names 1
- Amanda Rose Trout
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67671 | TX | MD | Professional Counselor |
| I-06248 | NM | MD | Clinical Social Worker |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561248000000",
"number": "1770724155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2163 BOWLES RNCH",
"city": "BELTON",
"state": "TX",
"postal_code": "765135866",
"telephone_number": "575-635-8947",
"fax_number": "254-519-3464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 E CENTRAL TEXAS EXPY",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765435315",
"telephone_number": "254-519-4162",
"fax_number": "254-519-3464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "AMANDA",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-16",
"last_updated": "2019-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-06248",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "67671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80137857",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "TROUT",
"middle_name": "ROSE",
"credential": "LISW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2019; 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.