Travis Ray Evans, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1193A Issued in ID

Practice address

98 Poplar St
Blackfoot, ID 83221-1758

Phone

(208) 782-3700

NPI assigned

Sep 19, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMH IncGroup PAC ID 8426149758, shared by 7 NPIs, 137 clinicians

Bingham Memorial HospitalGroup PAC ID 8426955014, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: travisevans@bmh.medalliesdirect.net

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.

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Medicare reassignment NPD
• BMH, Inc.

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193
  Medicare reassignment NPD
• BMH Inc.

  • Surgery Physician
  • Idaho Falls, ID
  • NPI 1922512722
  NPD
• BMH, Inc.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD
• BMH Inc.

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1770785875
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Care Compare affiliation

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1861742702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "TRAVIS",
        "middle_name": "RAY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1193A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kenette Ellin, NBC-HIS
• Ellis Chiropractic Inc
• Sadie Ellis, DPT
• Valden J Ellis, D.C.
• Debra Erramouspe, PA
• Matthew J Fackrell, DO
• Family Dental of Blackfoot LLC
• Family Pathways
• Family Pathways Cooperative
• Family Pathways Cooperative, Inc

• Family Nurse Practitioner in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.