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TRAVIS KANALY M.D.
Complete NPI Record 1750594099
Psychiatry & Neurology - Neurology in Edmond, OK


Quality Rating: 95.39 out of 100 score

NPI Status: Active since May 07, 2007

Contact Information

1705 RENAISSANCE BLVD STE 120
EDMOND, OK
ZIP 73013
Phone: (405) 844-8572
Fax: (405) 844-9143

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Credential Text
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Business Practice Location Address Fax Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Provider Gender Code
  23. Healthcare Provider Taxonomy Code 1
  24. Provider License Number 1
  25. Provider License Number State Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1750594099. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750594099
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: TRAVIS
The first name of the provider, if the provider is an individual.
Provider Credential Text: M.D.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 1701 RENAISSANCE BLVD STE 110
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: EDMOND
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OK
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 730133084
The State code in the location of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Telephone Number: 4058444978
The country code in the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 4058440562
The telephone number associated with the location address of the provider being identified.
Provider First Line Business Practice Location Address: 1705 RENAISSANCE BLVD STE 120
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address City Name: EDMOND
The date that a record was last updated or changed.
Provider Business Practice Location Address State Name: OK
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address Postal Code: 73013
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Country Code If outside U S : US
Provider Business Practice Location Address Telephone Number: 4058448572
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 4058449143
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/7/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/4/2019
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 2084N0400X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 24574
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: OK
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No