Autumn M Breon, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018302 Issued in PA

Practice address

43 S Main St
Montgomery, PA 17752-1120

Phone

(570) 547-0480

Fax

(570) 547-0498

NPI assigned

Jul 20, 2007

Last updated

May 23, 2008By 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 1

Addresses

Other identifiers 1

Other names 1

• Autumn M Weaver Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1053511774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST",
            "city": "MONTGOMERY",
            "state": "PA",
            "postal_code": "177521120",
            "telephone_number": "570-547-0480",
            "fax_number": "570-547-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST",
            "city": "MONTGOMERY",
            "state": "PA",
            "postal_code": "177521120",
            "telephone_number": "570-547-0480",
            "fax_number": "570-547-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREON",
        "first_name": "AUTUMN",
        "middle_name": "M",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017878210002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "WEAVER",
            "middle_name": "M",
            "credential": "D.P.T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Montgomery, PA
• Providers in Montgomery, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.