Individual provider Active NPI

Emilie Breeding, MS, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
National Provider Identifier
1174077333
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.019409 Issued in OH
Practice address
9049 Springboro Pike Ste a
Miamisburg, OH 45342-5057
Phone
(937) 759-0545
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.019409 OH Primary

Addresses

Primary practice location

9049 Springboro Pike Ste a
Miamisburg, OH 45342-5057

Mailing address

6402 Thornberry CT
Mason, OH 45040-7846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180608001712 OH Practitioner - Nurse Practitioner 2567717887 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Woodstream WellnessGroup PAC ID 8527462506, 55 clinicians

Practice addresses (Care Compare)

1911 Old Fairfield Rd
Suite 310
Beavercreek, OH 45432-2774
Phone (937) 759-0545

2555 University Dr
Suite 100
Fairborn, OH 45324-6255
Phone (937) 759-0545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
APRN.CNP.019409OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WS Wellness LLC Psychiatric/Mental Health CurrentSince Aug 1, 2023 Accepting new patients
Lee Side Wellness Associates, LLC Psychiatric/Mental Health CurrentSince Jul 28, 2020 Accepting new patients
Professional Psychiatric Services, LLC Past Accepting new patients

Locations

1911 Old Fairfield Rd
Ste 310
Beavercreek, OH 45432
Phone (937) 759-0545

5412 Courseview Dr
Ste 215
Mason, OH 45040
Phone (513) 204-1910

3615 Socialville Foster Rd
Ste C
Mason, OH 45040
Phone (513) 204-1910

9049 Springboro Pike
Miamisburg, OH 45342
Phone (937) 759-0545

9049 Springboro Pike
Ste A
Miamisburg, OH 45342
Phone (937) 759-0545

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1174077333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 THORNBERRY CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9049 SPRINGBORO PIKE STE A",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425057",
            "telephone_number": "937-759-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDING",
        "first_name": "EMILIE",
        "credential": "MS, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.019409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.