Individual provider Active NPI

Dwayne Breedlove, HIS

  • Hearing Instrument Specialist
  • Scottsdale, AZ
National Provider Identifier
1184232563
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HADE9268 Issued in AZ
Practice address
4807 E Greenway Rd Ste 3
Scottsdale, AZ 85254-9608
Phone
(602) 765-7800
NPI assigned
Jul 21, 2020
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HADE9268 AZ Primary

Addresses

Primary practice location

4807 E Greenway Rd Ste 3
Scottsdale, AZ 85254-9608

Mailing address

4807 E Greenway Rd Ste 3
Scottsdale, AZ 85254-9608
Phone (602) 765-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Scottsdale Direct

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

LicenseStateTypeSpecialty
HADE9268AZMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Better Hearing LLC CurrentSince Aug 2, 2020 Accepting new patients

Locations

4807 E Greenway Rd
Ste 3
Scottsdale, AZ 85254
Phone (480) 674-0633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1184232563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 E GREENWAY RD STE 3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852549608",
            "telephone_number": "602-765-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 E GREENWAY RD STE 3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852549608",
            "telephone_number": "602-765-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "DWAYNE",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "AZ",
            "license": "HADE9268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Scottsdale",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4807 E Greenway Rd Ste 3",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852549608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.