Individual provider Active NPI

Brenda J. Travis, M.S.

  • Speech-Language Pathologist
  • Bowie, MD
National Provider Identifier
1962705129
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01507 Issued in MD
Practice address
6915 Laurel-Bowie Road
Suite 205-F
Bowie, MD 20715
Phone
(240) 245-4370
Fax
(240) 245-4472
NPI assigned
Dec 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01507 MD Primary

Addresses

Primary practice location

6915 Laurel-Bowie Road
Suite 205-F
Bowie, MD 20715

Mailing address

6915 Laurel Bowie Rd
Suite 205-F
Bowie, MD 20715-1703
Phone (240) 245-4370

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Special Education Resources, LLC Speech-Language Pathologist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1962705129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 LAUREL BOWIE RD",
            "address_2": "SUITE 205-F",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151703",
            "telephone_number": "240-245-4370",
            "fax_number": "240-245-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 LAUREL-BOWIE ROAD",
            "address_2": "SUITE 205-F",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20715",
            "telephone_number": "240-245-4370",
            "fax_number": "240-245-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "BRENDA",
        "middle_name": "J.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.