Individual provider Active NPI

Terry L. Breitung, O.T.

  • Specialist
  • Mobile, AL
National Provider Identifier
1063466290
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0414 Issued in AL
Practice address
316 S Sage Ave
Ste. B
Mobile, AL 36606-3616
Phone
(251) 470-7772
Fax
(251) 470-7773
NPI assigned
May 20, 2006
Last updated
Jul 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0414 AL Primary

Addresses

Primary practice location

316 S Sage Ave
Ste. B
Mobile, AL 36606-3616

Mailing address

316 S Sage Ave
Ste. B
Mobile, AL 36606-3616
Phone (251) 470-7772

Other identifiers 2

IdentifierTypeStateIssuer
51079428OtherALBCBS
L172OtherALMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060628000316 AL Practitioner - Occupational Therapist in Private Practice 4789696113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Azalea City Hand and Rehab, Inc.Group PAC ID 4981701521, 2 clinicians

Practice addresses (Care Compare)

316 S Sage Ave
Suite B
Mobile, AL 36606-3616
Phone (251) 470-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Spine and Rehab Inc PastSince Apr 1, 2016 Accepting new patients
Azalea City Physical Therapy Specialist PastSince Jun 1, 2007 Accepting new patients
Total Spine Surgical Center LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1063466290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S SAGE AVE",
            "address_2": "STE. B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063616",
            "telephone_number": "251-470-7772",
            "fax_number": "251-470-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S SAGE AVE",
            "address_2": "STE. B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063616",
            "telephone_number": "251-470-7772",
            "fax_number": "251-470-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITUNG",
        "first_name": "TERRY",
        "middle_name": "L.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "0414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51079428",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "L172",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.