Active NPI
Travain Williams Sutphin, PHARM.D.
- Pharmacist
- Vinton, VA
National Provider Identifier
1861807117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202011738
- Practice address
- 9386 Hardy Rd
Vinton, VA 24179-5690 - Phone
- (540) 890-7788
- Fax
- (540) 890-6270
- NPI assigned
- Jun 25, 2014
- Last updated
- Jun 25, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202011738 | VA | Primary |
Addresses
Primary practice location
9386 Hardy Rd
Vinton, VA 24179-5690
Mailing address
9386 Hardy Rd
Vinton, VA 24179-5690
Phone (540) 890-7788
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202011738 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmerica Drug Systems LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403654400000",
"number": "1861807117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9386 HARDY RD",
"city": "VINTON",
"state": "VA",
"postal_code": "241795690",
"telephone_number": "540-890-7788",
"fax_number": "540-890-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9386 HARDY RD",
"city": "VINTON",
"state": "VA",
"postal_code": "241795690",
"telephone_number": "540-890-7788",
"fax_number": "540-890-6270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTPHIN",
"first_name": "TRAVAIN",
"middle_name": "WILLIAMS",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-25",
"last_updated": "2014-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202011738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vinton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.