MR. TREVIS LEE TREVINO (NPI# 1285001842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285001842 |
| Entity Type | Individual |
| Full Name | MR. TREVIS LEE TREVINO |
| Credential | C.S.M.S. |
| Practice Address |
915 Fairmount St Se Grand Rapids MI 49506-1555 |
| Practice Telephone | 6164321444 |
| Mailing Telephone | 6164321444 |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2020-04-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | T615802497876 | MI | Dietary & Nutritional Service Providers |
| N | 133N00000X | Nutritionist | CA | Dietary & Nutritional Service Providers | |
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
T615802497876 | MI | Allopathic & Osteopathic Physicians |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1643 Sunny Creek St Se, Grand Rapids, MI 495084968 | 6164321444 |
| Street Address |
915 FAIRMOUNT ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506-1555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366949455 | Nathan Larson | Preventive Medicine | 601 Quincy St., Athletics / Paavo Nurmi Gym, Hancock, MI 49930-4993 | 2018-04-06 |
| 1790230555 | Allison Frymier | Preventive Medicine | 799 N Hewitt Rd, Ypsilanti, MI 48197-1701 | 2016-08-22 |
| City | GRAND RAPIDS |
| Zip Code | 49506 |
Please comment or provide details below to improve the information on MR. TREVIS LEE TREVINO.
| 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.