Travis B. Bunnell, O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TRAVIS B. BUNNELL, O.D., P.C.

Practice address

727 E Broadway St
Fortville, IN 46040-1551

Phone

(317) 485-5146

Fax

(317) 485-5147

NPI assigned

Aug 22, 2005

Last updated

Jun 29, 2010By 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

Dr. Travis Brentt Bunnell, O.D.NPI 1629016175

Title

President

Phone

(317) 485-5146

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 1

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.

• Travis B Bunnell, O.D

  • Optometrist
  • Fortville, IN
  • NPI 1629016175
  Authorized official Same address or phone

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1992797211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460400100",
            "telephone_number": "317-485-5146",
            "fax_number": "317-485-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E BROADWAY ST",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460401551",
            "telephone_number": "317-485-5146",
            "fax_number": "317-485-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS B. BUNNELL, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "BUNNELL",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "BRENTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-485-5146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200978610A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410037718",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200193350A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reesa Smith, LMFT
• Cerissa Sperle, NP
• Diana Faye Stafford, RPT
• Bonnie Elaine Sweeney, MAOTR
• Jonathan Taylor
• Beth Turpin, N.P.
• Matthew Vanhorn
• Kalu Jane Vaughan, CPM, CDEM
• Vernon TWP Trustee (Vernon Township Fire Department)
• Kathryn W Vissing, OTR

• Optometrist in Fortville, IN
• Providers in Fortville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.