Organization Active NPI

Breakthrough Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1013612407
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BREAKTHROUGH PSYCHIATRY LLC
Practice address
803 W 4TH St Ste U
Pueblo, CO 81003-2392
Phone
(719) 423-0694
NPI assigned
Apr 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lilian Onwuka, NPNPI 1346977642
Title
Owner
Phone
(719) 423-0694

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

803 W 4TH St Ste U
Pueblo, CO 81003-2392

Mailing address

3000 Wedgewood Drive
PO Box 3834
Pueblo, CO 81005-0834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230821001275 CO Part B Supplier - Clinic/Group Practice 8123480308 Receives reassigned benefits from 1 practitioner
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

803 W 4th St
Ste U
Pueblo, CO 81003
Phone (719) 423-0694

3000 Wedgewood Dr
Unit 3834
Pueblo, CO 81005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1013612407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WEDGEWOOD DRIVE",
            "address_2": "PO BOX 3834",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810050834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W 4TH ST STE U",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032392",
            "telephone_number": "719-423-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "ONWUKA",
        "authorized_official_first_name": "LILIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-423-0694",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.