Marie L Brekken, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0143 Issued in ND

Practice address

1720 University Dr S
Fargo, ND 58103-4940

Phone

(701) 280-4375

Fax

(701) 461-5764

NPI assigned

Jul 16, 2006

Last updated

Sep 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Sanford Medical Center Fargo

  dba Sanford Health Occupational Medicine Clinic

  • Occupational Medicine Clinic/Center
  • Fargo, ND
  • NPI 1952323974
  NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1023035029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-280-4375",
            "fax_number": "701-461-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-280-4375",
            "fax_number": "701-461-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKEN",
        "first_name": "MARIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0143",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ND",
            "license": "PAC0143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry L Breidenbach, NP
• Breitbach Therapeutic Solutions PLLC
• Chase Bradley Breitbach, LCSW
• Dane Arthur Breker, M.D.
• Joanna Brekhus, DO
• James Mikel Breland
• Krista Bremner, RN, BSN
• Lukas John Brendemuhl, PEER SUPPORT
• Mary Ellen Breneman-Turner, PT
• Ethan Joseph Brenna, MSGC

• Physician Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.