Active NPI
Breanne Shrum, PTA, CFO
- Orthotic Fitter
- Morgantown, WV
National Provider Identifier
1144747189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- CFO04481
- Practice address
- 943 Maple Dr
Morgantown, WV 26505-2812 - Phone
- (304) 599-2515
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA002315 | WV | |
| Orthotic Fitter | 225000000X | CFO04481 | WV | Primary |
Addresses
Primary practice location
943 Maple Dr
Morgantown, WV 26505-2812
Mailing address
943 Maple Dr
Morgantown, WV 26505-2812
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 |
|---|---|---|---|
| CFO04481 | WV | MD | Orthotic Fitter |
| PTA002315 | WV | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503964800000",
"number": "1144747189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "943 MAPLE DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "943 MAPLE DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052812",
"telephone_number": "304-599-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRUM",
"first_name": "BREANNE",
"credential": "PTA, CFO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2017-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "PTA002315",
"primary": false
},
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "WV",
"license": "CFO04481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.