Individual provider Active NPI

Travis Annette Bittle, MA LPC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1992905749
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4234 Issued in NC
Practice address
3545 Whitehall Park Ste.
Ste. 300
Charlotte, NC 28273
Phone
(980) 302-8850
Fax
(704) 316-8118
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4234 NC
Mental Health Counselor 101YM0800X 4234 NC Primary

Addresses

Primary practice location

3545 Whitehall Park Ste.
Ste. 300
Charlotte, NC 28273

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-3550

Other practice location 1

8430 University Exec Park Dr
Suite 608
Charlotte, NC 28262-1350
Phone (704) 593-1106

Other practice location 2

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone (336) 718-3550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbittle128953@direct.novanthealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214002790 NC Practitioner - Mental Health Counselor 5193169498 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

13815 Professional Ctr Dr
Suite 100
Huntersville, NC 28078-7951
Phone (704) 384-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4234NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 1, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
NMG Health Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients

Locations

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1992905749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 WHITEHALL PARK STE.",
            "address_2": "STE. 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28273",
            "telephone_number": "980-302-8850",
            "fax_number": "704-316-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8430 University Exec Park Dr",
            "address_2": "Suite 608",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282621350",
            "country_code": "US",
            "telephone_number": "704-593-1106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036951",
            "country_code": "US",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BITTLE",
        "first_name": "TRAVIS",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "MA LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4234",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbittle128953@direct.novanthealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "175 Kimel Park Dr Ste 100",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.