Dr Travis Robert Bryant, OD is a medicare enrolled "Optometrist" provider in Ft. Campbell, Kentucky. His current practice location is
5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 412-9113.
Dr Travis Robert Bryant is licensed to practice in Arizona (license number OPT-002353) 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 1639711203.
Healthcare Provider's Profile
| Full Name | Dr Travis Robert Bryant |
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| Gender | Male |
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| Speciality | Optometrist |
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| Location | 5979 Desert Storm Ave., Ft. Campbell, Kentucky |
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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: 1639711203
- Provider Enumeration Date: 10/15/2019
- Last Update Date: 10/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 9133597578
- Enrollment ID: I20221116001515
Medical Identifiers
Medical identifiers for Dr Travis Robert Bryant such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1639711203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | OPT-002353 (Arizona) | 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. Dr Travis Robert Bryant allows following entities to bill medicare on his behalf.
| Provider Name | Lyndon Graves Enterprise Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1437436599
PECOS PAC ID: 5193992972
Enrollment ID: O20191030002728 |
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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. Dr Travis Robert Bryant 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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Dr Travis Robert Bryant, OD
200 S Hampton Pl Apt 10206,
Clarksville, TN 37040-6379
Ph: (480) 570-0235 | Dr Travis Robert Bryant, OD
5979 Desert Storm Ave., Lapointe Health Clnic Optometry,
Ft. Campbell, KY 42223
Ph: (270) 412-9113 |
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