MR. TRAVIS ANTHONY PETERSEN BA, MFA
NPI 1962257949
Technician/Technologist - Ocularist in Lehi, UT

Q: What is Travis Petersen's NPI number?

The NPI number for Travis Petersen is 1962257949. It was assigned to this individual provider in the NPPES registry on April 22, 2024.

Q: What is Travis Petersen's specialty?

The primary specialty registered for this NPI is Technician/Technologist, specializing in Ocularist, with taxonomy code 156FX1700X.

Q: When was this NPI record last updated?

The NPPES record for Travis Petersen was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.

Active since April 22, 2024

3305 W MAYFLOWER WAY STE 4, LEHI, UT 84048(833) 208-9009(866) 680-1322 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Travis Anthony Petersen Ba, Mfa NPPES

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

MR. TRAVIS ANTHONY PETERSEN BA, MFA (NPI 1962257949) is an individual ocularist provider in Lehi, Utah and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1962257949

Entity TypeIndividualMale

Primary Taxonomy156FX1700X

Provider Legal NameMR. TRAVIS ANTHONY PETERSENCredential: BA, MFA

Location Address3305 W MAYFLOWER WAY STE 4Lehi, UT 84048-2961

Mailing Address3305 W Mayflower Way Ste 4Lehi, UT 84048-2961 · (833) 208-9009 · Fax (866) 680-1322

Phone(833) 208-9009

Fax(866) 680-1322

Sole ProprietorYes

Enumeration DateApril 22, 2024

Last NPPES UpdateAugust 26, 2025

NPPES CertifiedAugust 26, 2025

✔ NPI 1962257949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician/Technologist · OcularistEye and Vision Services Providers

Taxonomy Code156FX1700X

Definition

An ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to creating custom ocular prostheses, and providing long-term care through periodic examinations, an ocularist provides the patient with complete instructions on the care and maintenance of their prosthesis.

3305 W MAYFLOWER WAY STE 4, Lehi, UT 84048

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

ADVANCED EYE PROSTHETICS LLC

Durable Medical Equipment & Medical Supplies

3305 W MAYFLOWER WAY STE 4
LEHI, UT 84048

(833) 208-9009

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 Travis Petersen's NPI number?

The NPI number for Travis Petersen is 1962257949. It was assigned to this individual provider in the NPPES registry on April 22, 2024.

Where is Travis Petersen located?

Travis Petersen practices at 3305 W Mayflower Way Ste 4, Lehi, UT 84048. The listed phone number is (833) 208-9009.

What is Travis Petersen's specialty?

The primary specialty registered for this NPI is Technician/Technologist, specializing in Ocularist, with taxonomy code 156FX1700X.

When was this NPI record last updated?

The NPPES record for Travis Petersen was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.