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MRS. LUCILLE TRAVIS NP
NPI 1093206674
Nurse Practitioner - Primary Care in Hiram, GA

Active since May 19, 2018PECOS EnrolledAccepts Medicare Assignment
4095 ATLANTA HWY, HIRAM, GA 30141(404) 488-9521(404) 836-8030 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 9, 2021, May 19, 2018 (2 updates tracked since 2018).

About Mrs. Lucille Travis Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LUCILLE TRAVIS NP (NPI 1093206674) is an individual primary care provider in Hiram, Georgia, licensed in Georgia (RN195568) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1093206674
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMRS. LUCILLE TRAVISCredential: NP
Location Address4095 ATLANTA HWYHiram, GA 30141-1854
Mailing Address4095 Atlanta HwyHiram, GA 30141-1854 · (404) 488-9521 · Fax (404) 836-8030
Phone(404) 488-9521
Fax(404) 836-8030
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMay 19, 2018
Last NPPES UpdateJanuary 17, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2024
✔ NPI 1093206674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in GA · RN195568
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License RN195568 (GA)
4095 ATLANTA HWY, Hiram, GA 30141
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Lucille Travis Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42569311
PECOS Enrollment IDI20180820002039
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREDEL PHARMACY
Pharmacy (Community/Retail Pharmacy)
4095 ATLANTA HWY
HIRAM, GA 30141
Paulding County (678) 202-4804
KINGDOM HEALTHCARE SERVICES, LLC
Clinic/Center (Primary Care)
4095 ATLANTA HWY
HIRAM, GA 30141
Paulding County (404) 488-9521

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lucille Travis's NPI number?

The NPI number for Lucille Travis is 1093206674. It was assigned to this individual provider in the NPPES registry on May 19, 2018.

Where is Lucille Travis located?

Lucille Travis practices at 4095 Atlanta Hwy, Hiram, GA 30141. The listed phone number is (404) 488-9521.

What is Lucille Travis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Lucille Travis enrolled in Medicare?

Yes. Lucille Travis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Lucille Travis was last updated on January 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.