Active NPI
Joel Breving, MD
- Psychiatry Physician
- Shreveport, LA
National Provider Identifier
1275742181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 308040
- Practice address
- 2924 Knight St Ste 410
Shreveport, LA 71105-2413 - Phone
- (859) 640-1727
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 308040 | LA | Primary |
Addresses
Primary practice location
2924 Knight St Ste 410
Shreveport, LA 71105-2413
Mailing address
2924 Knight St Ste 410
Shreveport, LA 71105-2413
Phone (859) 640-1727
Other practice location 1
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-6279
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017683 | Other | LA | PMP |
| 051144 | Other | LA | CDS LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308040 | LA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275742181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2924 KNIGHT ST STE 410",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052413",
"telephone_number": "859-640-1727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2924 KNIGHT ST STE 410",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052413",
"telephone_number": "859-640-1727"
}
],
"practiceLocations": [
{
"address_1": "475 Seaview Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103053436",
"country_code": "US",
"telephone_number": "718-226-6279",
"fax_number": "718-226-8144",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BREVING",
"first_name": "JOEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2023-03-07",
"certification_date": "2022-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "308040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PMP",
"identifier": "017683",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDS LICENSE",
"identifier": "051144",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
- Cameron Brenner, DO
- Brentwood Acquisition Shreveport, Inc (Brentwood Outpatient Clinic)
- Brentwood Acquisition Shreveport, Inc
- Brentwood Acquisition-Shreveport Inc. (Brentwood Hospital)
- Brentwood Acquisition-Shreveport Inc. (Brentwood Hospital)
- Brewer Physical Therapy & Associates LLC
- Adam R Brewer, PT, DPT
- Amanda Trekell Brewer, P.T.
- Angela Brewer
- Randall P. Brewer, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.