Active NPI
Travis Farrar
- Behavior Technician
- Putnam, CT
National Provider Identifier
1952077604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 79 Mechanics St Apt 2
Putnam, CT 06260-1318 - Phone
- (774) 601-3258
- NPI assigned
- Aug 20, 2021
- Last updated
- Sep 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | HYP.0000531 | CT | |
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
79 Mechanics St Apt 2
Putnam, CT 06260-1318
Mailing address
79 Mechanics St Apt 2
Putnam, CT 06260-1318
Phone (774) 230-1082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HYP.0000531 | CT | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1952077604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 MECHANICS ST APT 2",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601318",
"telephone_number": "774-230-1082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 MECHANICS ST APT 2",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601318",
"telephone_number": "774-601-3258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRAR",
"first_name": "TRAVIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CT",
"license": "HYP.0000531",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.