MR. TRAVIS L DESSOFFY


Address: 1025 Wh Smith Blvd Ste 108, Greenville, NC 27834-5278
Phone: 2522152215

MR. TRAVIS L DESSOFFY (NPI# 1376663534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376663534
Entity Type Individual
Full Name MR. TRAVIS L DESSOFFY
Credential CPO
Practice Address 1025 Wh Smith Blvd Ste 108
Greenville
NC 27834-5278
Mailing Address 5172 Us Highway 264 E
Greenville
NC 27834-5805
Practice Telephone 2522152215
Mailing Telephone 2529083731
Enumeration Date 2007-03-30
Last Update Date 2019-06-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 222Z00000X Orthotist CPO02116 NC Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 224P00000X Prosthetist CPO02116 NC Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 1376663534 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
113 Kandemor Ln, Rocky Mount, NC 278043212 2524435116 2524435347
4140 Ferncreek Dr Ste 803, Fayetteville, NC 28314 9104835737 9104832327

Office Location

Street Address 1025 WH SMITH BLVD STE 108
City GREENVILLE
State NC
Zip Code 27834-5278

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528572005 Braden D Teller Prosthetist 1025 Wh Smith Blvd Ste 108, Greenville, NC 27834-5278 2017-11-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841801255 Nicholas Mcarthur Bennett Day Training, Developmentally Disabled Services 302 C, Greenville, NC 27834 2020-08-11
1275150245 Shelby Renee Jones Student in an Organized Health Care Education/Training Program East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 2020-06-25
1194347138 Soban Ahmad Student in an Organized Health Care Education/Training Program 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 2020-05-13
1427687789 Brandon Allen Yates Student in an Organized Health Care Education/Training Program 435 Clinic Drive, Greenville, NC 27834 2020-04-07
1144854407 Kristen Springer Dreyfus Marriage & Family Therapist 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 2020-02-26
1861038606 Southern Surgical Outpatient Surgery Center, Pa Clinic/Center 2457 Emerald Place, Greenville, NC 27834 2019-11-26
1003460569 Shaun Fitzpatrick Nurse Practitioner Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 2019-08-01
1649831496 Katherine Salome Ross Genetic Counselor, MS 524 Moye Blvd, Greenville, NC 27834 2019-06-24
1477011880 Lauren Bethune Scroggs Counselor 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 2019-03-05
1669998001 Idella's Care Home Community/Behavioral Health 2912 Lee Ct # 9a, Greenville, NC 27834 2017-08-17
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Taxonomy Information

Taxonomy Code 224P00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Prosthetist

Taxonomy Definition

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912437930 Coastal Carolina Prosthetics & Orthotics, Inc. Prosthetist 1970 W Arlington Blvd Ste A, Greenville, NC 27834-5783 2017-06-13
1164963278 Travis Petersen Prosthetist 835 Johns Hopkins Dr, Suite B, Greenville, NC 27834-7268 2017-03-09
1114486529 Clarissa Rose Prosthetist 950 W Faris Rd, Greenville, SC 29605-4255 2019-03-15
1528572005 Braden D Teller Prosthetist 1025 Wh Smith Blvd Ste 108, Greenville, NC 27834-5278 2017-11-20
1275807174 Brian Kaluf Prosthetist 10 Enterprise Blvd, Suite 206, Greenville, SC 29615-6301 2012-02-24
1649558990 Brian Mcveigh Prosthetist 835 Johns Hopkins Dr Ste B, Greenville, NC 27834-7268 2011-08-03
1295990745 Steven Joseph Keeton Prosthetist 835 Johns Hopkins Dr Ste B, Greenville, NC 27834-7268 2008-07-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1639782857 Ashley Brooks Prosthetist 2232 Page Rd Ste 104, Durham, NC 27703-7724 2020-08-27
1689282865 Marquetta L Thomas Prosthetist 2203 Southern Ave, Fayetteville, NC 28306-2257 2020-07-14
1053943381 Ashley K Sorrell Prosthetist 24 Wood Lake Dr, Fuquay Varina, NC 27526-4936 2020-02-05
1134764459 Zachary Roggow Prosthetist 3400 Executive Dr Ste 102, Raleigh, NC 27609-7476 2019-11-11
1356990022 Porshai Juanice Jackson Prosthetist 6341 Derryfield Dr, Charlotte, NC 28213-5532 2019-09-05
1164079117 Sherronda Yancey Prosthetist 513 Yadkin St, Henderson, NC 27536-3524 2019-08-23
1962058909 Tishma Mcgarrell Prosthetist 102 N B Street, Bridgeton, NC 28519-2851 2019-08-15
1306400759 Pure Gold Luxz Hair Beauty Luxury Prosthetist 508 Owen Dr, Fayetteville, NC 28304-3417 2019-04-30
1437712601 Anitra Nash Phifer Prosthetist 2483 E Ozark Ave, Gastonia, NC 28054-1421 2019-04-15
1881257046 Sonja Allen Prosthetist 3509 David Cox Rd, Charlotte, NC 28269-2281 2019-04-15
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Competitor

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City GREENVILLE
Zip Code 27834

Improve Information

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Dataset Information

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.

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