Travis Lee Wiggins (NPI# 1396239547, PAC ID# 5890047328) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1396239547 |
| PAC ID by PECOS | 5890047328 |
| Professional Enrollment ID | I20181011001595 |
| Full Name | Travis Lee Wiggins |
| Organization Legal Name | EMERALD COAST URGENT CARE LLC |
| Address |
2704 Thomas Dr Panama City Beach FL 32408-6247 |
| Phone Number | 8502368655 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8224125869 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100026 | BAY MEDICAL CENTER SACRED HEART HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 12598 Us Hwy 98 W, Unit 101, Destin, FL 32550-2102 | 8506548878 | EMERALD COAST URGENT CARE LLC |
| 2704 Thomas Dr, Panama City Beach, FL 32408-6247 | 8502368655 | EMERALD COAST URGENT CARE LLC |
| Organization Legal Name | EMERALD COAST URGENT CARE LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacquelyn H Orcino | Physician Assistant | Emerald Coast Urgent Care LLC | 12598 Us Hwy 98 W, Unit 101, Destin, FL 32550-2102 |
| Lauren Vaughan | Physician Assistant | Emerald Coast Urgent Care LLC | 13625 E Emerald Coast Pkwy, Inlet Beach, FL 32461-7352 |
| Hillary L Glenn | Nurse Practitioner | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Timothy P Nichols | General Practice | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Marla Gail Denecke | Nurse Practitioner | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Daniel L Turley | Family Medicine | Emerald Coast Urgent Care LLC | 13625 E Emerald Coast Pkwy, Inlet Beach, FL 32461-7352 |
| Street Address |
2704 THOMAS DR |
| City | PANAMA CITY BEACH |
| State | FL |
| Zip | 32408-6247 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hillary L Glenn | Nurse Practitioner | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Timothy P Nichols | General Practice | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Marla Gail Denecke | Nurse Practitioner | Emerald Coast Urgent Care LLC | 2704 Thomas Dr, Panama City Beach, FL 32408-6247 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark D White | Chiropractic | 2427 Thomas Dr, Panama City Beach, FL 32408-5808 | |
| Myra A Reed | Family Medicine | 1814 Thomas Dr, Panama City Beach, FL 32408-5825 | |
| Leonel P Welch Basulto | Family Medicine | 2601 Thomas Dr, Panama City Beach, FL 32408-6222 | |
| Matthew Zechariah Welch | Family Medicine | 2601 Thomas Dr, Panama City Beach, FL 32408-6246 | |
| Donna Nichols | Physical Therapy | 7328 Thomas Dr B, Panama City Beach, FL 32408-7540 |
| City | PANAMA CITY BEACH |
| Zip Code | 32408 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PANAMA CITY BEACH + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Travis Lee Wiggins.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.