TRAVIS LEE TAYLOR (NPI# 1255597811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255597811 |
| Entity Type | Individual |
| Full Name | TRAVIS LEE TAYLOR |
| Credential | FNP-C, CRNFA |
| Practice Address |
30544 Highway 200 Ste 102 Ponderay ID 83852-5005 |
| Mailing Address |
335 S Lavina Ave Sandpoint ID 83864-1721 |
| Practice Telephone | 2082659817 |
| Mailing Telephone | 2089468219 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2014-07-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP-1376A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 163WR0006X |
Registered Nurse Specialization: Registered Nurse First Assistant |
N-37973 | ID | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881855708 | Travis Johnathan Taylor | Optometrist | 3400 State St Ste G770, Salem, OR 97301-7014 | 2008-06-23 |
| 1720289747 | Travis Dean Taylor | Physical Therapist | 1400 Nw 122nd St, Oklahoma City, OK 73114-8027 | 2007-05-29 |
| 1700986023 | Travis Henry Taylor IIi | Counselor | 2690 Memorial Blvd, Suite E4, Murfreesboro, TN 37129-5140 | 2006-09-25 |
| 1437266582 | Travis C Taylor | Emergency Medicine | 4300 Campus Ridg, Midland, MI 48640 | 2006-08-24 |
| 1134110851 | Travis Taylor | Optometrist | 415 D St, South Charleston, WV 25303-3107 | 2005-11-02 |
| 1912543349 | Travis Taylor | Behavior Technician | 4849 Lone Tree Way, Suite C, Antioch, CA 94531-8644 | 2019-11-20 |
| 1659935872 | Travis Jerod Taylor | Peer Specialist | 23899 State Highway 74, Purcell, OK 73080-6964 | 2019-04-23 |
| 1861948275 | Travis R Taylor | Marriage & Family Therapist | 17662 Irvine Blvd Ste 7, Tustin, CA 92780 | 2016-08-27 |
| 1194279620 | Travis Dwayne Taylor | Pharmacist | 933 Blackburn Ave, Ashland, KY 41101-4503 | 2016-08-12 |
| 1457782856 | Travis Ryan Taylor | Chiropractor | 20772 W Dixie Hwy, Aventura, FL 33180-1146 | 2013-12-10 |
| Street Address |
30544 HIGHWAY 200 STE 102 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| 1780651539 | Bruce William Demko | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2006-03-01 |
| 1679110845 | Angela Alice Chapin | Massage Therapist | 30544 Highway 200, Ponderay, ID 83852-5005 | 2019-12-05 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932758083 | Graham Charles Andrews | Nurse Practitioner | 400 Schweitzer Plaza Dr Ste 1, Ponderay, ID 83852-9819 | 2019-09-10 |
| 1669756813 | Nichole Suzanne Grimm | Nurse Practitioner | 30544 Highway 200, Ste 101, Ponderay, ID 83852-5005 | 2011-10-06 |
| 1821003708 | Ammara, Inc. | Nurse Practitioner | 30410 Highway 200, Ponderay, ID 83852-9601 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
| 1710588108 | Lauren Proteau | Nurse Practitioner | 310 S Acer Loop, Post Falls, ID 83854-8809 | 2020-11-03 |
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1023617347 | Kristina Oliver | Nurse Practitioner | 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-2668 | 2020-10-19 |
| 1730787482 | John Dustin Pena | Nurse Practitioner | 102 Courthouse Dr Ste F, Salmon, ID 83467-3905 | 2020-10-14 |
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1659979516 | Jennifer Anne Gardner | Nurse Practitioner | 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 | 2020-10-13 |
| 1982210795 | Samuel Hally | Nurse Practitioner | 1346 Cimarron Ct, Middleton, ID 83644-5894 | 2020-09-17 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
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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.