Travis John Laverne, PA-C

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

25MP00616900 Issued in NJ

Practice address

100 NJ-73
Voorhees Township, NJ 08043

Phone

(856) 282-1338

NPI assigned

Dec 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1831795327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NJ-73",
            "city": "VOORHEES TOWNSHIP",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-282-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NJ-73",
            "city": "VOORHEES TOWNSHIP",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-282-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERNE",
        "first_name": "TRAVIS",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MP00616900",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MP00616900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Besaw
• Alex Cera
• Harsh Patel DPM PA
• HCP Voorhees Township NJ Opco, LLC (Atria Voorhees)
• Ashlee Maruca, LPC
• Benjamin Smith
• Tamara Tisdale
• John J Wilson, MD

• Plastic Surgery Physician in Voorhees Township, NJ
• Providers in Voorhees Township, NJ by specialty
• Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.

Verify at the official NPI Registry.