Individual provider Active NPI

Tonya Breeding, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1053336081
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA503 Issued in KY
Practice address
1720 Nicholasville Rd
Sutie 601
Lexington, KY 40503-1404
Phone
(859) 277-5887
Fax
(859) 276-7638
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA503 KY Primary

Addresses

Primary practice location

1720 Nicholasville Rd
Sutie 601
Lexington, KY 40503-1404

Mailing address

1720 Nicholasville Rd
Sutie 601
Lexington, KY 40503-1404
Phone (859) 277-5887

Other identifiers 1

IdentifierTypeStateIssuer
9500270500MedicaidKY

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)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1053336081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD",
            "address_2": "SUTIE 601",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031404",
            "telephone_number": "859-277-5887",
            "fax_number": "859-276-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD",
            "address_2": "SUTIE 601",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031404",
            "telephone_number": "859-277-5887",
            "fax_number": "859-276-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDING",
        "first_name": "TONYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500270500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.