NPIMap

Individual provider Active NPI

Philip Stanley Travis, M.D.

  • Nephrology Physician
  • Mobile, AL
National Provider Identifier
1952386641
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
15173 Issued in AL
Practice address
124A S University Blvd
Mobile, AL 36608
Phone
(251) 343-5004
Fax
(251) 343-8383
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15173 AL
Nephrology Physician 207RN0300X 15173 AL Primary

Addresses

Primary practice location

124A S University Blvd
Mobile, AL 36608

Mailing address

P.O. Box 850849
Mobile, AL 36685-0849
Phone (251) 343-5004

Other identifiers 2

IdentifierTypeStateIssuer
000082241MedicaidAL
51082241OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000997 AL Practitioner - Nephrology 3678570009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Mississippi School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Mobile, P.a.Group PAC ID 8729061668, 41 clinicians

Practice addresses (Care Compare)

124 S University Blvd
Suite a
Mobile, AL 36608-3078

124 S University Blvd a
Mobile, AL 36608-3078
Phone (251) 343-5004

3250 Airport Blvd
Suite C
Mobile, AL 36606-3800
Phone (251) 343-5004

Hospital & facility affiliations

  • FMC East Mobile Dialysis facility, Mobile, AL, CCN 012524
  • FMC Mobile Transitional Care and Home Therapies Dialysis facility, Mobile, AL, CCN 012719
  • Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
  • Springhill Medical Center Hospital, Mobile, AL, CCN 010144
  • USA Health HCA Providence Hospital, LLC Hospital, Mobile, AL, CCN 010090
  • Monroe County Hospital Hospital, Monroeville, AL, CCN 011310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15173ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Mobile, P.a. Specialist CurrentSince Nov 7, 1994 Accepting new patients

Locations

2505 Hand Ave
Bay Minette, AL 36507
Phone (251) 433-1180

2505 Hand Ave
Ste A
Bay Minette, AL 36507

124 S University Blvd
Ste A
Mobile, AL 36608
Phone (251) 342-5053

Interoperability endpoints

  • Direct secure messaging: ptravis26326@direct.acumenmd.com

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1952386641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 850849",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850849",
            "telephone_number": "251-343-5004",
            "fax_number": "251-343-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124A S UNIVERSITY BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36608",
            "telephone_number": "251-343-5004",
            "fax_number": "251-343-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "PHILIP",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "15173",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "15173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082241",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51082241",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.