TRAVIS BERGER (NPI# 1275060998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275060998 |
| Entity Type | Individual |
| Full Name | TRAVIS BERGER |
| Credential | DO |
| Practice Address |
1400 S Forge Rd Ste 1 Palmyra PA 17078-9513 |
| Practice Telephone | 7178381301 |
| Practice Fax Number | 7178385811 |
| Mailing Telephone | 7178381301 |
| Mailing Fax Number | 7178385811 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS020465 | PA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | OT017689 | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10484 Jonestown Rd, Annville, PA 170038434 | 7178656647 | 7178650324 |
| Street Address |
1400 S FORGE RD STE 1 |
| City | PALMYRA |
| State | PA |
| Zip Code | 17078-9513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548676364 | Ingrid Bakalorz Blubaugh | Family Medicine | 1400 S Forge Rd Ste 1, Palmyra, PA 17078-9519 | 2014-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916239 | Lolita Feld | Family Medicine | 941 Park Drive, Palmyra, PA 17078 | 2019-08-08 |
| 1508384736 | Kelly Renee Black | Specialist/Technologist | 503 North Chestnut Street, Palmyra, PA 17078 | 2017-09-08 |
| 1174857643 | Jason John Castro | Occupational Therapist | 1273 South Forge Road, Palmyra, PA 17078 | 2009-09-30 |
| 1962694174 | Timothy Ryan Corl | Optometrist | 2901 Horseshoe Pike, Palmyra, PA 17078 | 2007-08-11 |
| 1740349216 | Ck Kc Inc | Pharmacy | 22 East Main Street, Palmyra Pharmacy & Gift Shop, Palmyra, PA 17078 | 2006-12-08 |
| 1396839742 | Khanh T. Bui | Pharmacist | 30 W. Main Street, Palmyra, PA 17078 | 2006-10-02 |
| 1548369028 | Ck-kc Ltc, Inc | Pharmacy | 1200 Grubb Street, Palmyra, PA 17078 | 2006-09-21 |
| 1669846507 | Kelly Christine Morris | Occupational Therapist | 2880 Horseshoe Pike, Palmyra, PA 17078 | 2015-11-16 |
| 1003287558 | Corl Eyecare, LLC | Optometrist | 2901 Horseshoe Pike, Palmyra, PA 17078 | 2015-10-09 |
| 1972727238 | Philhaven Residential | Psychiatric Residential Treatment Facility | 231 E Main St, Palmyra, PA 17078 | 2007-04-11 |
| Find all providers in zip 17078 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916239 | Lolita Feld | Family Medicine | 941 Park Drive, Palmyra, PA 17078 | 2019-08-08 |
| 1558767509 | Rugh Henderson I | Family Medicine | 945 Stauffers Church Rd, Palmyra, PA 17078-9607 | 2014-11-18 |
| 1548676364 | Ingrid Bakalorz Blubaugh | Family Medicine | 1400 S Forge Rd Ste 1, Palmyra, PA 17078-9519 | 2014-07-02 |
| 1700146099 | John Rexis Aguilar | Family Medicine | 58 Dogleg Rd, Palmyra, VA 22963-2312 | 2012-05-21 |
| 1750309142 | Samang O Kim | Family Medicine | 6996 County Road 326, Palmyra, MO 63461-3119 | 2006-07-17 |
| 1194758227 | Adrian J Hohenwarter | Family Medicine | 745 South Grant Street, Palmyra, PA 17078-3215 | 2006-07-09 |
| 1356389498 | Floyd Memorial Hospital and Health Services | Family Medicine | 691 Main Street Ne, Palmyra Family Medicine, Palmyra, IN 47164-8894 | 2006-06-02 |
| 1225003841 | The Milton S Hershey Medical Center Physicians Group | Family Medicine | 941 Park Dr, Palmyra, PA 17078-3445 | 2006-02-17 |
| 1366414385 | Phyllis Blattstain Montellese | Family Medicine | 2599 Central Plains Rd, Palmyra, VA 22963 | 2006-02-03 |
| 1962481663 | Hannibal Clinic Operations, L.L.C. | Family Medicine | 1811 S Main St, Palmyra, MO 63461-1961 | 2006-01-11 |
| Find all providers in PALMYRA | ||||
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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.