Individual provider Active NPI

Ruth Ann Breitenbach, RN

  • Diabetes Educator Registered Nurse
  • Clackamas, OR
National Provider Identifier
1033412630
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
200442245 Issued in OR
Practice address
10180 SE Sunnyside Road
Clackamas, OR 97015-9303
Phone
(503) 571-4468
Fax
(503) 571-4291
NPI assigned
Dec 21, 2010
Last updated
Dec 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 200442245 OR Primary

Addresses

Primary practice location

10180 SE Sunnyside Road
Clackamas, OR 97015-9303

Mailing address

10180 SE Sunnyside Road
Clackamas, OR 97015-9303
Phone (503) 571-4468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
200442245ORMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1033412630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE ROAD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159303",
            "telephone_number": "503-571-4468",
            "fax_number": "503-571-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE ROAD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159303",
            "telephone_number": "503-571-4468",
            "fax_number": "503-571-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITENBACH",
        "first_name": "RUTH",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OR",
            "license": "200442245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.