Devin Adam Breckenridge, MD
Individual provider Active NPI Family Medicine Physician · Fayette, MO
NPI 1144980467 · NPPES record last updated Jun 30, 2025
Key facts
- NPI
- 1144980467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2025023214 (MO)
- Practice address
- 308 S Church St
Fayette, MO 65248-1243 - Phone
- (660) 248-2217
- NPI assigned
- Dec 28, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250710002408 | MO | Order and Referring Only - Family Practice |
2769996669 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MO | ||
| Family Medicine Physician | 207Q00000X | 2025023214 | MO | Yes |
Addresses
Primary practice location
308 S Church St
Fayette, MO 65248-1243
Mailing address
1 Hospital Dr
Columbia, MO 65212-1243
Phone (573) 884-2912
Other practice location 1
3501 Greeley Dr
Columbia, MO 65202-2739
Phone (660) 483-0789
Other providers in Fayette, MO
- Tiffany Lynn Ballough
- Trevor Michael Barbour
- BDM Associates LLC
- Jessica Michelle Beasley
- Ashley Diane Belstle
- Bristol Care, Inc.
- Robert Neal Buffaloe
- Central Methodist Univeristy
- Central Methodist University
- Central Methodist University
All providers in Fayette, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.