Individual provider Active NPI

Lee Andrew Breshears, DVM, PHD, DACVS

  • Veterinarian
  • Parker, CO
National Provider Identifier
1174967913
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
VET.0008977 Issued in CO
Practice address
17701 Cottonwood Dr
Parker, CO 80134-3939
Phone
(720) 842-5050
Fax
(720) 842-5060
NPI assigned
Apr 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X VET.0008977 CO Primary

Addresses

Primary practice location

17701 Cottonwood Dr
Parker, CO 80134-3939

Mailing address

17701 Cottonwood Dr
Parker, CO 80134-3939
Phone (720) 842-5050

Other identifiers 1

IdentifierTypeStateIssuer
VET.0008977OtherCOCOLORADO DIVISION OF REGULATORY AGENCIES - VETERINARY LISCENCE NUMBER

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
VET.0008977COMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Creek Veterinary Services LLC Past Accepting new patients

Organizations & group practices 1

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1174967913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17701 COTTONWOOD DR",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343939",
            "telephone_number": "720-842-5050",
            "fax_number": "720-842-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17701 COTTONWOOD DR",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343939",
            "telephone_number": "720-842-5050",
            "fax_number": "720-842-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESHEARS",
        "first_name": "LEE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DVM, PHD, DACVS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "CO",
            "license": "VET.0008977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DIVISION OF REGULATORY AGENCIES - VETERINARY LISCENCE NUMBER",
            "identifier": "VET.0008977",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.