| Travis Fawver, DO | |
|
435 2nd St, Newport, TN 37821-3703 | |
| (423) 625-2200 | |
| Not Available |
| Full Name | Travis Fawver |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 22 Years |
| Location | 435 2nd St, Newport, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467490805 | NPI | - | NPPES |
| P00310644 | Other | TN | RAILROAD MEDICARE |
| 3319552 | Medicaid | TN | |
| 4113345 | Other | TN | BCBS OF TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 1710 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Physicians Regional Medical Center | Powell, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeastern Emergency Physicians Llc | 2466364997 | 627 |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050207000666 |
| Entity Name | Tri-cities Regional Emergency Physicians, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063950046 PECOS PAC ID: 3678859477 Enrollment ID: O20170410002399 |
| Entity Name | App Of East Tennessee Ed Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326695537 PECOS PAC ID: 6800127796 Enrollment ID: O20191007003318 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20210806002739 |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Fawver, DO Po Box 636019, Cincinnati, OH 45263-6019 Ph: (865) 985-7234 | Travis Fawver, DO 435 2nd St, Newport, TN 37821-3703 Ph: (423) 625-2200 |
Constantino Diaz Miranda, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 435 2nd Street, Newport, TN 37821 Phone: 423-625-2200 | |
Dr. Wayne Berry Iii, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 407 4th St, Newport, TN 37821 Phone: 423-623-6240 Fax: 423-623-0102 | |
David L Shumway, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 435 2nd St, Newport, TN 37821 Phone: 800-577-7707 Fax: 865-769-3476 |