TRAVIS BRAULT (NPI# 1841641859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841641859 |
| Entity Type | Individual |
| Full Name | TRAVIS BRAULT |
| Credential | P.A.-C |
| Practice Address |
1111 S Stapley Dr Mesa AZ 85204-5059 |
| Practice Telephone | 6023027900 |
| Mailing Telephone | (602) 302-7900 |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2017-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1111 S STAPLEY DR |
| City | MESA |
| State | AZ |
| Zip Code | 85204-5059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568433787 | Jennifer Elhabiby | Optometrist | 1111 S Stapley Dr, Mesa, AZ 85204-5015 | 2006-01-27 |
| 1063013506 | Geoffrey B Carr | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-11-02 |
| 1639777220 | Mary E Pals | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-10-15 |
| 1467050195 | Linsey M Mettenbrink | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-10-14 |
| 1578198479 | Adrienne Rabick | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-03-11 |
| 1972135390 | Terros, Inc. | Community/Behavioral Health | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-02-05 |
| 1366072399 | Jennifer L Spaude | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-01-17 |
| 1124664362 | Diana M Kirby | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2019-11-22 |
| 1376189894 | Amanda M Chavez | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2019-11-19 |
| 1720555030 | Terros Inc | Clinic/Center | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2018-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734686 | Joshua Luke Adams | Physician Assistant | 5264 E Carol Ave, Mesa, AZ 85206-1304 | 2020-06-09 |
| 1508417957 | Joe Panelli | Physician Assistant | 524 S 88th St, Mesa, AZ 85208-8213 | 2019-09-26 |
| 1275183600 | Allie Finney | Physician Assistant | 4135 S Power Rd Ste 129, Mesa, AZ 85212-3627 | 2019-09-17 |
| 1972158459 | Jason Pearce | Physician Assistant | 8334 E Peralta Ave, Mesa, AZ 85212-1677 | 2019-08-01 |
| 1265086409 | Madison Ziser | Physician Assistant | 2604 E Downing Cir, Mesa, AZ 85213-6824 | 2019-07-25 |
| 1790341170 | Mark William Nelms | Physician Assistant | 4839 S Antonio, Mesa, AZ 85212-5191 | 2019-05-11 |
| 1235607292 | Amber Leeann Valenzuela | Physician Assistant | 2345 E Southern Ave Unit 101, Mesa, AZ 85204-5419 | 2018-11-07 |
| 1417423146 | Neda Yasmin Yanch | Physician Assistant | 2505 N Raven Cir, Mesa, AZ 85207-2063 | 2018-10-20 |
| 1336615590 | Nicholas J. Deyoung | Physician Assistant | 5058 E Southern Ave Ste 102, Mesa, AZ 85206-2771 | 2018-10-15 |
| 1417432063 | Jordan Tyler Foulger | Physician Assistant | 3248 E Jacinto Ave, Mesa, AZ 85204-7336 | 2018-09-29 |
| Find all providers in MESA | ||||
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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.