Individual provider Active NPI

Michael B Travis, D.C.

  • Chiropractor
  • Benton, KY
National Provider Identifier
1902005861
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
249695 Issued in KY
Practice address
374 W 5TH St
Benton, KY 42025-1102
Phone
(270) 906-2700
Fax
(270) 906-2800
NPI assigned
Jul 12, 2007
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5058 KY
Chiropractor 111N00000X 249695 KY Primary

Addresses

Primary practice location

374 W 5TH St
Benton, KY 42025-1102

Mailing address

374 W 5TH St
Benton, KY 42025-1102
Phone (270) 906-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071112000005 KY Practitioner - Chiropractic 0648368589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chaney Bug Health Services PSCGroup PAC ID 8123143294, 2 clinicians

Practice addresses (Care Compare)

374 W 5TH St
Benton, KY 42025-1102
Phone (270) 906-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249695KYMDChiropractor
5058KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chaney Bug Health Services PSC Chiropractor CurrentSince Jun 13, 2010 Accepting new patients
Graves County Health Services PSC Chiropractor CurrentSince Mar 5, 2019 Accepting new patients

Locations

374 W 5th St
Benton, KY 42025
Phone (270) 609-2700

1011 Paris Rd
Ste 341
Mayfield, KY 42066
Phone (270) 251-0907

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.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1902005861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 W 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251102",
            "telephone_number": "270-906-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 W 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251102",
            "telephone_number": "270-906-2700",
            "fax_number": "270-906-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5058",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "249695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.