Active NPI
Kristy Michele Breitbach, MOT, OTR/L
- Occupational Therapist
- Mesa, AZ
National Provider Identifier
1215452248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6910
- Practice address
- 1025 N Country Club Dr
Mesa, AZ 85201-3307 - Phone
- (847) 828-4766
- NPI assigned
- Aug 10, 2017
- Last updated
- Aug 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6910 | AZ | Primary |
Addresses
Primary practice location
1025 N Country Club Dr
Mesa, AZ 85201-3307
Mailing address
1025 N Country Club Dr
Mesa, AZ 85201-3307
Phone (847) 828-4766
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6910 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Making Milestones, PLLC | Occupational Therapist | 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, 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": "1502323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502323200000",
"number": "1215452248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 N COUNTRY CLUB DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852013307",
"telephone_number": "847-828-4766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 N COUNTRY CLUB DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852013307",
"telephone_number": "847-828-4766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREITBACH",
"first_name": "KRISTY",
"middle_name": "MICHELE",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-10",
"last_updated": "2017-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "6910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.