Travis Nolan, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fleming Island, Florida. His current practice location is
2200 Marsh Hawk Ln Unit 615, Fleming Island, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 294-7247.
Travis Nolan is licensed to practice in Florida (license number SW17486) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205448560.
Healthcare Provider's Profile
| Full Name | Travis Nolan |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 2200 Marsh Hawk Ln Unit 615, Fleming Island, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205448560
- Provider Enumeration Date: 08/18/2020
- Last Update Date: 02/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 2567854128
- Enrollment ID: I20220112000890
Medical Identifiers
Medical identifiers for Travis Nolan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205448560 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | SW17486 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW17486 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Travis Nolan allows following entities to bill medicare on his behalf.
| Entity Name | Mcr Health Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255376000
PECOS PAC ID: 7214847995
Enrollment ID: O20040126000213 |
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| Entity Name | Balanced Wellbeing Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336513639
PECOS PAC ID: 5193021848
Enrollment ID: O20160307002587 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Travis Nolan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Travis Nolan, LCSW
2200 Marsh Hawk Ln Unit 615,
Fleming Island, FL 32003-4315
Ph: (904) 294-7247 | Travis Nolan, LCSW
2200 Marsh Hawk Ln Unit 615,
Fleming Island, FL 32003-4315
Ph: (904) 294-7247 |
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