Individual provider Active NPI

Wendy Turner Travis, NP-C

  • Family Nurse Practitioner
  • Greenville, MS
National Provider Identifier
1881001568
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R855747 Issued in MS
Practice address
1467 Highway 1 S
Greenville, MS 38701-7141
Phone
(662) 335-1621
Fax
(662) 335-8128
NPI assigned
Jul 15, 2014
Last updated
Jul 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R855747 MS Primary

Addresses

Primary practice location

1467 Highway 1 S
Greenville, MS 38701-7141

Mailing address

PO Box 4618
Greenville, MS 38704-4618
Phone (662) 335-1621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20141230001205 MS Practitioner - Nurse Practitioner 8921321845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Greenville Family Medical Center, Inc.Group PAC ID 5395742555, 3 clinicians

Practice addresses (Care Compare)

1467 Hwy 1 S
Greenville, MS 38701-7141
Phone (601) 335-1621

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R855747MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Family Medical Center Inc CurrentSince Sep 1, 2014 Accepting new patients
Delta Regional Anesthesiology Group Past Accepting new patients

Locations

1467 Highway 1 S
Greenville, MS 38701
Phone (601) 335-1621

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1881001568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4618",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044618",
            "telephone_number": "662-335-1621",
            "fax_number": "662-335-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387017141",
            "telephone_number": "662-335-1621",
            "fax_number": "662-335-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "WENDY",
        "middle_name": "TURNER",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.