Individual provider Active NPI

Breanna R Veal, PA-C

  • Medical Physician Assistant
  • Dayton, OH
National Provider Identifier
1073806923
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50003273 Issued in OH
Practice address
7707 Paragon Rd
Suite 101
Dayton, OH 45459-4041
Phone
(937) 208-6920
Fax
(937) 208-6948
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50003273 OH Primary

Addresses

Primary practice location

7707 Paragon Rd
Suite 101
Dayton, OH 45459-4041

Mailing address

7707 Paragon Rd
Suite 101
Dayton, OH 45459-4041
Phone (937) 208-6920

Other identifiers 1

IdentifierTypeStateIssuer
0067879MedicaidOH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110613000266 OH Practitioner - Physician Assistant 6305023789 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50003273OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Mar 1, 2012 Accepting new patients
Mvhe, Inc CurrentSince Mar 1, 2012 Accepting new patients

Locations

7707 Paragon Rd
Ste 101
Dayton, OH 45459
Phone (937) 208-6920

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1073806923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7707 PARAGON RD",
            "address_2": "SUITE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594041",
            "telephone_number": "937-208-6920",
            "fax_number": "937-208-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 PARAGON RD",
            "address_2": "SUITE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594041",
            "telephone_number": "937-208-6920",
            "fax_number": "937-208-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEAL",
        "first_name": "BREANNA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50003273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067879",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.