Active NPI
Rebecca P Travis, D.P.T.
- Physical Therapist
- Waterloo, NY
National Provider Identifier
1861828949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 036587-1
- Practice address
- 1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202 - Phone
- (315) 539-5067
- NPI assigned
- Sep 19, 2013
- Last updated
- Oct 3, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 036587-1 | NY | Primary |
Addresses
Primary practice location
1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202
Mailing address
1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202
Phone (315) 539-5067
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036587-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1861828949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1083 WATERLOO GENEVA RD",
"city": "WATERLOO",
"state": "NY",
"postal_code": "131651202",
"telephone_number": "315-539-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1083 WATERLOO GENEVA RD",
"city": "WATERLOO",
"state": "NY",
"postal_code": "131651202",
"telephone_number": "315-539-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "REBECCA",
"middle_name": "P",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-19",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "036587-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.