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MIMOSA TRAVIS FNP
NPI 1457920563
Nurse Practitioner - Family in Memphis, TN

Active since June 22, 2021PECOS Enrolled
2594 KIMBALL AVE, MEMPHIS, TN 38114(901) 596-0058 Get Directions Write a Review

NPPES record last updated: June 22, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mimosa Travis Fnp NPPES

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

MIMOSA TRAVIS FNP (NPI 1457920563) is an individual family provider in Memphis, Tennessee, licensed in Tennessee (27862) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457920563
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMIMOSA TRAVISCredential: FNP
Location Address2594 KIMBALL AVEMemphis, TN 38114-4301
Mailing Address2594 Kimball AveMemphis, TN 38114-4301 · (901) 596-0058
Phone(901) 596-0058
Sole ProprietorNo
Enumeration DateJune 22, 2021
NPPES CertifiedJune 22, 2021
✔ NPI 1457920563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 27862
2594 KIMBALL AVE, Memphis, TN 38114
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mimosa Travis Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mimosa Travis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Signify Health, LLC
421 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Missouri enrollment
  • 412 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007
Signify Health Medical Associates, PLLC
421 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Tennessee enrollment
  • 528 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38114 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

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 Mimosa Travis's NPI number?

The NPI number for Mimosa Travis is 1457920563. It was assigned to this individual provider in the NPPES registry on June 22, 2021.

Where is Mimosa Travis located?

Mimosa Travis practices at 2594 Kimball Ave, Memphis, TN 38114. The listed phone number is (901) 596-0058.

What is Mimosa Travis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mimosa Travis enrolled in Medicare?

Yes. Mimosa Travis is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mimosa Travis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mimosa Travis reassigns Medicare benefits to 2 organizations: Signify Health, LLC (Dallas, TX) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mimosa Travis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mimosa Travis was last updated on June 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.