Travis J Spagnola

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070016338 Issued in IL

Practice address

17236 Harlem Ave
Tinley Park, IL 60477-6619

Phone

(708) 633-8379

Fax

(708) 633-8614

NPI assigned

Apr 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Achieve Orthopedic Sports Institute LLCGroup PAC ID 6507129673, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Achieve Orthopedic Sports Institute, LLC

  • Physical Therapy Clinic/Center
  • Willowbrook, IL
  • NPI 1376066753

  IL

  Medicare reassignment Care Compare group NPD
• Achieve Orthopedic Rehabilitation Institute,Inc

  • Physical Therapist
  • Chicago, IL
  • NPI 1053331447

  IL, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1992978175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 170TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291451",
            "telephone_number": "708-335-1415",
            "fax_number": "708-335-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17236 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776619",
            "telephone_number": "708-633-8379",
            "fax_number": "708-633-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAGNOLA",
        "first_name": "TRAVIS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Community Services, Inc
• Southwest Community Services, Inc.
• Southwest Physical Therapy and Rehabilitation, LTD
• Southwest Sports & Spinal Rehab Inc
• Southwest Surgical Excellence
• Special Care Nurses of America, LLC
• Specialty Needs Transportation, Inc.
• Speech Made Easy Inc.
• Spine Iq, LLC
• SPJ Mobility LLC

• All providers in Tinley Park, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.