Travis Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11061 Issued in AL

Legal business name

TRAVIS CLINIC

Practice address

312 US Hwy 80 E # 3
Demopolis, AL 36732-3619

Phone

(334) 289-9408

Fax

(334) 289-1160

NPI assigned

Oct 19, 2007

Last updated

Nov 13, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Waverly D Bedsole

Title

Office Manager

Phone

(334) 289-9408

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Canebreak Medical Former legal business name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Judy Cooke Travis, MD

  • Family Medicine Physician
  • Demopolis, AL
  • NPI 1518051788
  Medicare reassignment NPD
• Deirdre M Aycock, CRNP

  • Family Nurse Practitioner
  • Pine Hill, AL
  • NPI 1588927453
  NPD
• Lauren Goddard, CRNP

  • Nurse Practitioner
  • Greensboro, AL
  • NPI 1295194447
  NPD
• John C Simmons, MD

  • General Practice Physician
  • Linden, AL
  • NPI 1104832724
  NPD
• Cinnamon Travis Cramer, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Demopolis, AL
  • NPI 1639276702
  NPD (past)

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1902095565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1159",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367321159",
            "telephone_number": "334-289-9408",
            "fax_number": "334-289-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 US HWY 80 E # 3",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367323619",
            "telephone_number": "334-289-9408",
            "fax_number": "334-289-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "BEDSOLE",
        "authorized_official_first_name": "WAVERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-289-9408"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "11061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51082149",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082149",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canebreak Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tombigbee Healthcare Authority (Whitfield Regional Hospital)
• Tombigbee Healthcare Authority (Whitfield Regional Hospital)
• Tombigbee Healthcare Authority (Whitfield Regional Hospital Geri-Psych Unit)
• Tombigbee Healthcare Authority (Whitfield Regional Hospital Swing Bed)
• Tombigbee Healthcare Authority (Whitfield Regional Hospital Home Health Agency)
• Judy Cooke Travis, MD
• Amy U Tucker, RD LD
• Jamie Lynn Tucker, PHARMD
• Urgent Care Northwest PC (MedCenter Demopolis, LLC)
• Todd Bagwell Vaughan, MD

• Family Medicine Physician in Demopolis, AL
• Providers in Demopolis, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.