TRAVIS B WILSON (NPI# 1053408591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053408591 |
| Entity Type | Individual |
| Full Name | TRAVIS B WILSON |
| Credential | P.A. |
| Practice Address |
140 W Main St Suite 100 Springfield OH 45502-1312 |
| Practice Telephone | 9373981066 |
| Practice Fax Number | 9373981076 |
| Mailing Telephone | 9373981066 |
| Mailing Fax Number | 9373981076 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2011-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2723 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 1140 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | DEA | MW2183060 | 01 |
| OH | PA LICENSE | 2723 | 01 |
| OH | CAQH | 11949409 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235695933 | Travis Alexander Wilson | Physical Medicine & Rehabilitation | 10415 State Highway 151 Ste 101, San Antonio, TX 78251-4553 | 2019-02-18 |
| 1568688711 | Travis Dean Wilson | Counselor | 8258 W Orbit Dr, Boise, ID 83709-7876 | 2007-04-17 |
| 1366875767 | Travis J Wilson | Pharmacist | 235 Camden St, Rockland, ME 04841-2563 | 2013-08-21 |
| 1114289022 | Travis J Wilson | Orthopaedic Surgery | 16020 Park Valley Dr, Round Rock, TX 78681-3573 | 2012-06-15 |
| 1336422476 | Travis Wilson | Case Manager/Care Coordinator | 902 S High St, Columbia, TN 38401-3204 | 2011-09-26 |
| 1154532729 | Travis David Wilson | Anesthesiology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2007-05-25 |
| 1922181999 | Travis W. Wilson | Dentist | 1042 N Main St, Beaver Dam, KY 42320-1553 | 2006-10-23 |
| Street Address |
140 W MAIN ST SUITE 100 |
| City | SPRINGFIELD |
| State | OH |
| Zip Code | 45502-1312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851912109 | Ohio Valley Medical Center, LLC | Clinical Medical Laboratory | 140 W Main St, Springfield, OH 45502-1368 | 2020-04-28 |
| 1780133025 | Logan Blair | Specialist/Technologist | 140 W Main St, Springfield, OH 45502-1368 | 2016-09-28 |
| 1427441534 | Danielle Workman | Specialist/Technologist | 140 W Main St, Springfield, OH 45502-1312 | 2015-03-13 |
| 1629477369 | Jenna Zumberger | Occupational Therapist | 140 W Main St, Springfield, OH 45502-1312 | 2014-08-19 |
| 1760820708 | Matthew Pigott | Orthopaedic Surgery | 140 W Main St, Springfield, OH 45502 | 2013-06-12 |
| 1982626982 | Springfield Orthopaedic and Sports Medicine Institute LLC | Orthopaedic Surgery | 140 W Main St, Suite 100, Springfield, OH 45502-1312 | 2006-07-25 |
| 1295778546 | David B. Galluch | Orthopaedic Surgery | 140 W Main St, Suite 100, Springfield, OH 45502-1312 | 2006-06-14 |
| 1619928371 | Ian Martin Thompson | Orthopaedic Surgery | 140 W Main St, Suite 100, Springfield, OH 45502-1312 | 2006-05-15 |
| 1548250954 | Michael Matthew Milam | Physician Assistant | 140 W Main St, Suite 100, Springfield, OH 45502-1312 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093232449 | Jennifer Susanne Mitchell Denney | Registered Nurse | 3710 Snyder Domer, Springfield, OH 45502 | 2017-08-26 |
| 1649512138 | Kathleen J Oxner | Internal Medicine | 2100 Emmanuel Way Ste B, Springfield, OH 45502 | 2013-03-22 |
| 1255667648 | Stacey Lynn Harpest | Licensed Practical Nurse | 2960 Dayton Springfield Road, Springfield, OH 45502 | 2009-10-20 |
| 1477714475 | Christian A Victor | Dentist | 1980 Kingsgate Rd., Suite A, Springfield, OH 45502 | 2008-06-23 |
| 1508916743 | Helen Louise Chapman | Home Health Aide | 7610 Troy Rd, Springfield, OH 45502 | 2007-01-11 |
| 1891845160 | Clark Dental Care Inc | Dentist | 1980 A Kings Gate Rd, Suite A, Springfield, OH 45502 | 2007-01-11 |
| 1144387820 | Philip Joseph Gibeau | Psychologist | 20 South Limestone St Ste 340, Springfield, OH 45502 | 2007-01-02 |
| 1730707480 | Jeffrey Blaine Randall | Counselor | 4867 Urbana Rd, Springfield, OH 45502 | 2020-07-09 |
| 1013573989 | Dion Stevens | Peer Specialist | 4867 Urbana Rd, Springfield, OH 45502 | 2019-05-15 |
| 1538304050 | Ohio Valley Medical Center, LLC | General Acute Care Hospital | 100 W. Main Street, Springfield, OH 45502 | 2008-12-12 |
| Find all providers in zip 45502 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123289 | Jared Anthony Dias | Physician Assistant | 52 Devens St, Springfield, MA 01151-2304 | 2020-04-16 |
| 1659990976 | Maham Siddiqui | Physician Assistant | 8632 Hillside Manor Dr, Springfield, VA 22152-2238 | 2020-04-16 |
| 1558994772 | Kayla Rice | Physician Assistant | 3640 Main St Ste 103, Springfield, MA 01107-1139 | 2020-02-17 |
| 1487286563 | Michayla Marcil | Physician Assistant | 280 Chestnut St Fl 2, Springfield, MA 01199-1001 | 2020-02-06 |
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1023670593 | Michael Peter Lembotesis | Physician Assistant | 629 Evans Rd, Springfield, PA 19064-3033 | 2019-07-03 |
| 1245795558 | Alexandra Marie Cutler | Physician Assistant | 1437 S Gelven Ave, Springfield, MO 65804-2124 | 2019-01-31 |
| 1598265894 | Kelsey L. Magill | Physician Assistant | 3231 S National Ave Ste 440, Springfield, MO 65807-7304 | 2018-02-14 |
| 1447759592 | Darrell Dewain Edwards | Physician Assistant | 4350 S National Ave Ste C200, Springfield, MO 65810-2782 | 2018-02-05 |
| 1164930087 | Ashley Jean Nichole Leutze | Physician Assistant | 1164 E Home Rd Ste J, Springfield, OH 45503-2726 | 2018-01-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 45502 |
Please comment or provide details below to improve the information on TRAVIS B WILSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.