Breckinridge Sievers Smith II

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0002745 Issued in DE

Practice address

Kent General Hospital Emergency Department
640 South State St.
Dover, DE 19901

Phone

(302) 674-4700

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Breck Sievers Smith Professional name

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Bayhealth Medical Center, Inc.

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1679072144
  Medicare reassignment NPD
• Bayhealth Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1073012696
  Medicare reassignment
• Bayhealth Medical Center, Inc

  • Gastroenterology Physician
  • Milford, DE
  • NPI 1639938525
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1073698619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 SEDGEWICK DR",
            "city": "MAGNOLIA",
            "state": "DE",
            "postal_code": "199623203",
            "telephone_number": "302-697-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KENT GENERAL HOSPITAL EMERGENCY DEPARTMENT",
            "address_2": "640 SOUTH STATE ST.",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-674-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRECKINRIDGE",
        "middle_name": "SIEVERS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C0002745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRECK",
            "last_name": "SMITH",
            "middle_name": "SIEVERS",
            "prefix": "MR.",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lisa Elphick Smale, DO
• Smile to Smile Family Dental & Sedation Center, P.a.
• Smith Consultant Group LLC
• Nicole Smith-Mosley, RBT
• Annette Smith
• Cache Renna Smith
• Calysha Smith, LMSW
• Cheryl Smith
• Daisy Smith
• Deidra Smith, DISABILITY COACH

• Medical Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Medical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.