Travis Wayne Sullivan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14409 Issued in TX

Practice address

101 E Broadway St
Prosper, TX 75078-2934

Phone

(972) 347-9933

Fax

(682) 292-2997

NPI assigned

Aug 3, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perriton Chiropractic LLCGroup PAC ID 6305251000, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Perriton Chiropractic LLC

  • Chiropractor
  • Prosper, TX
  • NPI 1215302500
  Medicare reassignment Care Compare group NPD
• Chiropractic Health Center

  • Chiropractor
  • Lawrence, KS
  • NPI 1801931530
  NPD (past)

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1912138348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY ST",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782934",
            "telephone_number": "972-347-9933",
            "fax_number": "682-292-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY ST",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782934",
            "telephone_number": "972-347-9933",
            "fax_number": "682-292-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TRAVIS",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05275",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "14409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn E Stoos, DO
• Benjamin Stovall
• Nickolas Antony Stroh, PA-C
• Iscairelys Suarez
• Allison Sullivan, APRN, FNP-C
• Sunshine Family Psychiatry PLLC
• Supllies Med LLC
• Thomas Swallow
• Swell Steps Therapy
• Sweta Sheth DDS Prosper PLLC

• Chiropractor in Prosper, TX
• Providers in Prosper, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.