Individual provider Active NPI

Breanna Lien, FNP-C

  • Family Nurse Practitioner
  • West Lake Hills, TX
National Provider Identifier
1154704229
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128431 Issued in TX
Practice address
701 S Capital of Texas Hwy
Ste 900
West Lake Hills, TX 78746-5243
Phone
(512) 324-6970
NPI assigned
Jul 7, 2015
Last updated
Mar 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128431 TX Primary

Addresses

Primary practice location

701 S Capital of Texas Hwy
Ste 900
West Lake Hills, TX 78746-5243

Mailing address

4616 W Howard LN
Austin, TX 78728-6300

Other identifiers 1

IdentifierTypeStateIssuer
358503604MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20201216002406 WY Practitioner - Nurse Practitioner 3375849219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

501 S Burma Ave
Gillette, WY 82716-3426
Phone (307) 688-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128431TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District Current Accepting new patients
Campbell County Clinics - Endocrinology CurrentSince Jan 4, 2021 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Jan 4, 2021 Accepting new patients
Campbell County Hospital District Past Accepting new patients
St. David's Carenow Urgent Care PLLC PastSince Dec 19, 2016 Accepting new patients

Locations

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

Interoperability endpoints

  • Direct secure messaging: blien262125@ahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1154704229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 W HOWARD LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787286300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S CAPITAL OF TEXAS HWY",
            "address_2": "STE 900",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465243",
            "telephone_number": "512-324-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEN",
        "first_name": "BREANNA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358503604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.