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General NPI Number Information
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NPI Number | 1356814982
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Entity Type | Individual
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Provider Name | TRAVIS RANDALL MCPIKE NP-C
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Gender | Male
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1152 E US HIGHWAY 36
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City | BAINBRIDGE
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State | IN
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Zip | 46105-9604
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Country | US
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Telephone | 765-522-1889
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Fax | 765-522-3583
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Provider Business Mailing Address
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Address Line | 1100 SOUTHFIELD DR STE 1370
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City | PLAINFIELD
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State | IN
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Zip | 46168-4300
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Country | US
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Telephone | 317-837-5570
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Fax | 317-837-5580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28213528A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71008690A
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License Number State | IN
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