Travis Pemelton Phillips, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4871 Issued in AL

Practice address

1695 Golden Springs Rd
Anniston, AL 36207-7097

Phone

(256) 831-1333

Fax

(256) 831-1837

NPI assigned

Aug 15, 2006

Last updated

Feb 1, 2013By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Travis P. Phillips, DMD, LLC

  • General Practice Dentistry
  • Anniston, AL
  • NPI 1568702074
  NPD (past) Authorized official
• Al Dental Professionals PC

  • General Practice Dentistry
  • Anniston, AL
  • NPI 1821832585
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1881707057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 GOLDEN SPRINGS RD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362077097",
            "telephone_number": "256-831-1333",
            "fax_number": "256-831-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 GOLDEN SPRINGS RD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362077097",
            "telephone_number": "256-831-1333",
            "fax_number": "256-831-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRAVIS",
        "middle_name": "PEMELTON",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51520429",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "971939",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatrics Plus, P.C.
• Leslie Murray Peek, FNP-C
• Audrey Pentecost
• Keyanna Peters, LPC
• Janya Phillips
• Terry M Phillis Jr., MD
• Physicians Choice Dialysis of Calhoun County LLC (Physicians Choice Dialysis of Anniston I)
• Physicians Choice Dialysis of Calhoun County LLC (Physicians Choice Dialysis of Anniston II)
• Physicians Medical Staffing LLC
• Elizabeth Anne Pickering, DMD

• General Practice Dentistry in Anniston, AL
• Providers in Anniston, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.