DR. TRAVIS SCOTT ROBERTSON (NPI# 1386253623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386253623 |
| Entity Type | Individual |
| Full Name | DR. TRAVIS SCOTT ROBERTSON |
| Credential | PHARMD |
| Practice Address |
463855 State Road 200 Yulee FL 32097-3639 |
| Mailing Address |
1000 Island Point Dr Apt 1110 Jacksonville FL 32218-5655 |
| Practice Telephone | 9042612405 |
| Mailing Telephone | 9546464626 |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS61046 | FL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NONE | NA | 01 | |
| NA | NA | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| 1538264825 | Travis James Robertson | Chiropractor | 3221 16th Ave Sw, Cedar Rapids, IA 52404-1434 | 2006-09-13 |
| Street Address |
463855 STATE ROAD 200 |
| City | YULEE |
| State | FL |
| Zip Code | 32097-3639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083996482 | Marci Dillard | Pharmacist | 463855 State Road 200, Yulee, FL 32097-3639 | 2011-09-13 |
| 1245753185 | Jennifer Drummond | Pharmacist | 463855 State Road 200, Yulee, FL 32097-3639 | 2017-07-23 |
| 1285971283 | Nicholas Burke | Pharmacist | 463855 State Road 200, Yulee, FL 32097-3639 | 2013-01-10 |
| 1962776286 | Publix Super Markets Inc | Pharmacy | 463855 State Road 200, Yulee, FL 32097-3639 | 2012-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104432012 | Sinead Carr | Speech-Language Pathologist | Pediatric Therapy Associates, 463380 State Rd 200 Unit A, Yulee, FL 32097 | 2020-09-17 |
| 1932749298 | Lekira Elmore Taylor | Nurse's Aide | 951421 Bridge Parkway, Fernandina Beach, FL 32097 | 2020-01-14 |
| 1003451816 | Faculty Associates, Inc | Dentist | 76011 William Burgess Boulevard, Yulee, FL 32097 | 2019-11-15 |
| 1932744414 | Beckham's Holdings,llc | Eyewear Supplier (Equipment, not the service) | 463688 Fl-200, Suite 9, Yulee, FL 32097 | 2019-11-08 |
| 1740836048 | University of Florida Jacksonville Physicians Inc | Clinic/Center | 76011 William Burgess Blvd, Yulee, FL 32097 | 2019-08-13 |
| 1669039400 | Genesis Health Development, Inc. | Clinic/Center | 463721 Sr 200, Suite 7, Jacksonville, FL 32097 | 2019-05-28 |
| 1366981540 | Shannon C Taylor | Occupational Therapist | 75136 Ravenwood Drive, Yulee, FL 32097 | 2017-02-21 |
| 1982063244 | Suzanne J Leffew | Nurse Practitioner | 463646 Sr 200 West, Ste. 12, Yulee, FL 32097 | 2016-02-15 |
| 1558737163 | Sun Gallery Enterprises | Eyewear Supplier (Equipment, not the service) | 463867 Sr 200, Suite 4, Yulee, FL 32097 | 2015-08-18 |
| 1962777177 | Spirit Enterprises | Skilled Nursing Facility | 9035 Brian Dairy Road, Largo Health Center, Largo, FL 32097 | 2012-03-21 |
| Find all providers in zip 32097 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154758381 | Naveen Kumar Palarapu | Pharmacist | 463688 State Road 200 Ste 6, Yulee, FL 32097-0304 | 2013-10-02 |
| 1083996482 | Marci Dillard | Pharmacist | 463855 State Road 200, Yulee, FL 32097-3639 | 2011-09-13 |
| 1861772386 | Gretchen Riker Gardner | Pharmacist | 86655 Riverwood Dr, Yulee, FL 32097 | 2011-08-29 |
| 1346557345 | Yvette Stevens | Pharmacist | 86053 Meadowfield Bluffs Rd, Yulee, FL 32097-8414 | 2010-09-12 |
| 1205143856 | Elizabeth Stophel Hotchkiss | Pharmacist | 96076 Lofton Sq Ct, Yulee, FL 32097 | 2010-09-02 |
| 1760518575 | Olanrewaju Bankole IIi | Pharmacist | 22 Lofton Square Blvd, Yulee, FL 32097 | 2007-02-26 |
| 1790385144 | Jeffrey Paul Berteau | Pharmacist | 464016 State Road 200, Yulee, FL 32097-6339 | 2020-10-27 |
| 1235776261 | Ivanna Holmgren | Pharmacist | 96076 Lofton Square Ct, Yulee, FL 32097-6347 | 2019-12-10 |
| 1215496583 | Wesley K Singleton | Pharmacist | 463688 State Road 200 Ste 6, Yulee, FL 32097-0304 | 2019-03-17 |
| 1245753185 | Jennifer Drummond | Pharmacist | 463855 State Road 200, Yulee, FL 32097-3639 | 2017-07-23 |
| Find all providers in YULEE | ||||
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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.