Breakthrough Services Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

BREAKTHROUGH SERVICES INC.

Practice address

114A Memorial Dr
Jacksonville, NC 28546-6328

Phone

(910) 347-6009

Fax

(910) 355-2267

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Jackie Christian Bodnarik

Title

Fiscal Director

Phone

(910) 347-6009

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Breakthrough Homes and Services Former legal business name

Locations

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1306017165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114A MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-347-6009",
            "fax_number": "910-355-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114A MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-347-6009",
            "fax_number": "910-355-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BODNARIK",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "FISCAL DIRECTOR",
        "authorized_official_telephone_number": "910-347-6009",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418095",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301307",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301307B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301307G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breakthrough Homes and Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jacob Kohl Branham, DPT
• Casie Clay Branson, MSW, LCSWA
• Gerald Oliver Brant Jr., IDC
• Megan Thomas Brauninger, OTR/L
• Madison Alexandria Brawner, LCSWA
• Charles Edward Brett Jr.
• Johnathon T Brewer, IDC
• Joshua Brewster
• Amber Breyer, BSN, RN, IBCLC
• Paula Briedis, LPC

• Preferred Provider Organization in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Preferred Provider Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.