Breanna McNellis

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126003989 Issued in VA

Practice address

601 Childrens LN
Norfolk, VA 23507-1971

Phone

(757) 708-2879

NPI assigned

Sep 13, 2022

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1346962826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 STARLING ST APT 103",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224388",
            "telephone_number": "417-689-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071971",
            "telephone_number": "757-708-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELLIS",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126003989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa McNeil
• McNeill Therapy & Testing
• Douglas Hugh McNeill, MD
• Jeninne McNeill, PH.D., LCP
• Suganthi McNeill, DMD
• Madison McNicholas
• Hugh Thomas McPhee, MD
• Fiora Lynn McRae, MD
• Lakeera McRath
• Jeffrey Donald McTavish, MD

• Athletic Trainer in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.