Travis Mark Remington, MPAS, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4859842-1206 Issued in UT

Practice address

5169 Cottonwood St
Suite# 410
Murray, UT 84107-6767

Phone

(801) 507-1650

Fax

(801) 507-1625

NPI assigned

Sep 19, 2007

Last updated

Apr 13, 2009By the provider in NPPES

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1851587133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5169 COTTONWOOD ST",
            "address_2": "SUITE# 410",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076767",
            "telephone_number": "801-507-1650",
            "fax_number": "801-507-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5169 COTTONWOOD ST",
            "address_2": "SUITE# 410",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076767",
            "telephone_number": "801-507-1650",
            "fax_number": "801-507-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMINGTON",
        "first_name": "TRAVIS",
        "middle_name": "MARK",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "4859842-1206",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "4859842-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Murray, UT
• Providers in Murray, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.