TRAVIS AUSTIN (NPI# 1417575994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417575994 |
| Entity Type | Individual |
| Full Name | TRAVIS AUSTIN |
| Practice Address |
1718 Falls Blvd N Wynne AR 72396-4022 |
| Mailing Address |
304 N 6th St West Memphis AR 72301-3221 |
| Practice Telephone | 8702384014 |
| Practice Fax Number | 8702384231 |
| Mailing Telephone | 8707321878 |
| Mailing Fax Number | 8707027657 |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073670550 | Travis James Austin | Dentist | Bldg 38801 Academic Dr Ste B,c, Usa Dentac, Ft Gordon, GA 30905 | 2007-01-03 |
| 1043818198 | Travis Austin | Community Health Worker | 162 N 400 E Ste A105, St George, UT 84770-7192 | 2020-10-12 |
| 1003250440 | Travis Wade Austin | Preventive Medicine | 4951 S White Mountain Rd Bldg A, Show Low, AZ 85901-7801 | 2013-04-27 |
| Street Address |
1718 FALLS BLVD N |
| City | WYNNE |
| State | AR |
| Zip Code | 72396-4022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881830727 | Life Strategies of Arkansas | Clinic/Center | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2008-12-24 |
| 1427668896 | Madison Naceanceno | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2020-07-31 |
| 1104343862 | Bippy Poage | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2017-08-24 |
| 1902275688 | Anita Carter | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2015-09-23 |
| 1790179513 | Ashia Caldwell | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2015-03-19 |
| 1588933485 | Janetta Cross Parchman | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2011-12-21 |
| 1215206289 | Linda Stoner Waddell | Social Worker | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2011-12-21 |
| 1013200724 | Joyce Mary Ray | Social Worker | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2011-05-27 |
| 1548494214 | Lara Lyons | Social Worker | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2009-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962918813 | David Makool | Occupational Therapy Assistant | 2000 Gogbill Road, Wynne, AR 72396 | 2017-12-14 |
| 1912425554 | Barbara Ann Burgess | Case Manager/Care Coordinator | 661 Addison, Wynne, AR 72396 | 2017-09-05 |
| 1518481308 | Tyler Leigh Shumard | Physical Therapy Assistant | 128 County Road 145, Wynne, AR 72396 | 2017-08-02 |
| 1588957476 | Northeast Arkansas Community Mental Health Center | Counselor | 661 Addison Dr., Wynne, AR 72396 | 2011-05-25 |
| 1417106493 | Katherine Danielle Calhoun | Dietitian, Registered | 1013 Bridges Ave East, Wynne, AR 72396 | 2008-09-15 |
| 1053531319 | George Scott Puryear, Dds, Pa | Dentist | 715 East Eldrdige Avenue, Wynne, AR 72396 | 2007-04-27 |
| 1730245465 | Marilyn J Cullum | Counselor | 1742 Falls Blvd. Suite 5, The Logan Center, Wynne, AR 72396 | 2006-12-28 |
| 1770655185 | Robert Walton Bassham | Dentist | 669 Addison Drive, Wynne, AR 72396 | 2006-11-14 |
| 1073683827 | George Scott Puryear Jr. | Dentist | 715 E. Eldridge Ave, Wynne, AR 72396 | 2006-11-09 |
| 1194809517 | Richard Keeter Toland | Dentist | 2100 North Killough, Wynne, AR 72396 | 2006-10-24 |
| Find all providers in zip 72396 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861058802 | Lacey Pulley | Case Manager/Care Coordinator | 750 Bridges Ave E Ste E, Wynne, AR 72396-2343 | 2019-05-15 |
| 1912425554 | Barbara Ann Burgess | Case Manager/Care Coordinator | 661 Addison, Wynne, AR 72396 | 2017-09-05 |
| 1801232517 | Maranda Stallings | Case Manager/Care Coordinator | 750 Bridges Ave E, Wynne, AR 72396-2327 | 2013-05-21 |
| 1427668896 | Madison Naceanceno | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2020-07-31 |
| 1114562774 | Jherica James | Case Manager/Care Coordinator | 750 Bridges Ave E Ste E, Wynne, AR 72396-2343 | 2019-11-07 |
| 1063068419 | Zachary Grant Nethercutt | Case Manager/Care Coordinator | 661 Addison Dr, Wynne, AR 72396-1602 | 2019-08-12 |
| 1508418567 | Katherine Hitchcock | Case Manager/Care Coordinator | 750 Bridges Ave E Ste E, Wynne, AR 72396-2343 | 2019-07-10 |
| 1306317870 | Kimberly Dawn Hunt-thornhill | Case Manager/Care Coordinator | 661 Addison Dr, Wynne, AR 72396-1602 | 2018-12-10 |
| 1225547953 | Melanie Faith Whitaker | Case Manager/Care Coordinator | 661 Addison Dr, Wynne, AR 72396-1602 | 2017-09-26 |
| 1104343862 | Bippy Poage | Case Manager/Care Coordinator | 1718 Falls Blvd N, Wynne, AR 72396-4022 | 2017-08-24 |
| Find all providers in WYNNE | ||||
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| 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.