Individual provider Active NPI

Jeri Breiner, PH.D.

  • Cognitive & Behavioral Psychologist
  • Atlanta, GA
National Provider Identifier
1083837827
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
PSY001117 Issued in GA
Practice address
6075 Roswell Rd NE
Suite 400
Atlanta, GA 30328-4008
Phone
(770) 933-0220
Fax
(404) 255-9254
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PSY001117 GA Primary

Addresses

Primary practice location

6075 Roswell Rd NE
Suite 400
Atlanta, GA 30328-4008

Mailing address

5825 Glenridge Dr NE
BLDG. 3, Suite 101C
Atlanta, GA 30328-5387
Phone (770) 933-0220

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001117GAMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1083837827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 GLENRIDGE DR NE",
            "address_2": "BLDG. 3, SUITE 101C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285387",
            "telephone_number": "770-933-0220",
            "fax_number": "404-255-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 ROSWELL RD NE",
            "address_2": "SUITE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284008",
            "telephone_number": "770-933-0220",
            "fax_number": "404-255-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREINER",
        "first_name": "JERI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY001117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.