Active NPI
Mark Breeding, MSPT, ATC
- Physical Therapist
- Browns Mills, NJ
National Provider Identifier
1134755168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00664600
- Practice address
- 200 Trenton Rd
Browns Mills, NJ 08015-1705 - Phone
- (609) 893-6611
- NPI assigned
- Mar 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00664600 | NJ | Primary |
Addresses
Primary practice location
200 Trenton Rd
Browns Mills, NJ 08015-1705
Mailing address
1025 Haines Mill Rd
Moorestown, NJ 08057-4006
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00664600 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584748800000",
"number": "1134755168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 HAINES MILL RD",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080574006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TRENTON RD",
"city": "BROWNS MILLS",
"state": "NJ",
"postal_code": "080151705",
"telephone_number": "609-893-6611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEDING",
"first_name": "MARK",
"credential": "MSPT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-21",
"last_updated": "2020-03-21",
"certification_date": "2020-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00664600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Browns Mills, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.