MARY ANN TRAVILLIAN (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1306469994

MARY ANN TRAVILLIAN (APRN) is a healthcare provider. based in Beaver dam, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 1106020 (KY). The NPI Number for MARY ANN TRAVILLIAN (APRN) is 1306469994

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MARY ANN TRAVILLIAN (APRN)
NPI
1306469994
Phone
(270) 256-7473
Address
1050 BALD KNOB RD
Enumeration Date
18 May 2020
Last Update Date
2 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2703601222
Graduation Year
2020 (6 years ago)
PAC ID
0345652525
Group Practice PAC ID
7719911023
Professional Enrollment ID
I20201228002464
Address ID
KY427011417EL204XXSTXX400
Telehealth
Yes

Contacts

Main Contact
mhmadrt@gmail.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:6State licenses:2Other namesUpdated within 12 months

7,347 NURSE PRACTITIONER in KY

Provider Addresses for MARY ANN TRAVILLIAN (APRN)

  • 1050 BALD KNOB RD

    BEAVER DAM, KY 423209402

    Phone: (270) 256-7473

    Type: Mailing

  • 1050 Bald Knob Rd

    Beaver Dam, KY 423209402

    Phone: (270) 256-7473

    Type: Location

  • 204 N MAIN ST

    ELIZABETHTOWN, KY 427011417

    Phone: (270) 360-1222

    Fax: (270) 360-0333

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 38 Open Payments records for all available years, with a total value of $467.

Total Amount is formed as General ($467) + Research ($0) + Ownership ($0) = $467.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: ABBVIE INC. ($176).

Total Amount

$467

General + Research + Ownership

Payments

38

Total payment records

General Amount

$467

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-12-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201228002464INurse PractitionerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42320)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719911023View full group profile
NameSpecialtyState
Clinical Social WorkerKY
Clinical PsychologistKY
Clinical Social WorkerKY
Clinical Social WorkerKY
-KY
Nurse PractitionerKY

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARY ANN TRAVILLIAN (APRN)?
MARY ANN TRAVILLIAN (APRN) — NPI 1306469994 — is the standard way to identify this listing.
Does the file indicate MARY ANN TRAVILLIAN (APRN) is practicing under active NPI?
Directory data currently reports MARY ANN TRAVILLIAN (APRN) as active.
What is MARY ANN TRAVILLIAN (APRN)'s primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for MARY ANN TRAVILLIAN (APRN) here. Clinical services aligned with this taxonomy classification.
What address line appears for MARY ANN TRAVILLIAN (APRN)?
MARY ANN TRAVILLIAN (APRN)'s geographic hint is Beaver Dam, Kentucky in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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