Gerald Breedlove, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0013055 Issued in OH

Practice address

3058 Latimer Rd
Rock Creek, OH 44084-9632

Phone

(440) 563-9144

NPI assigned

Dec 14, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lake Orthopaedic Associates, Inc.

  • Orthopaedic Surgery Physician
  • Chardon, OH
  • NPI 1942470174
  NPD
• Agm Physical Therapy, LLC

  • Specialist
  • Mentor, OH
  • NPI 1689691776
  NPD (past)
• Lake Hospital System, Inc

  dba Lake Health Urgent Care and Walk In Clinic

  • Urgent Care Clinic/Center
  • Chardon, OH
  • NPI 1689634966
  NPD (past)

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1184927147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3058 LATIMER RD",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849632",
            "telephone_number": "440-563-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 LATIMER RD",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849632",
            "telephone_number": "440-563-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-14",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT0013055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Balint, RN
• Teresa Lynne Ball, LISW-CS
• Kyle Beer
• Scott Lee Bell
• Nicole Blascak
• Emilie Grace Burr
• Mary Frances Capitena-Bento, LICDC-CS
• Mary Colvin
• Raymond Countryman
• Kari Craig, DPT

• Physical Therapist in Rock Creek, OH
• Providers in Rock Creek, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.