Breanna Nicole Sprague

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

42 River St
Chateaugay, NY 12920-2002

Phone

(518) 497-6611

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Female

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)

Not enrolled

Practice roles

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.

• Chateaugay Central School

  • Local Education Agency (LEA)
  • Chateaugay, NY
  • NPI 1043376775
  NPD (past)

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1356196315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 COUNTY ROUTE 25",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129536018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 RIVER ST",
            "city": "CHATEAUGAY",
            "state": "NY",
            "postal_code": "129202002",
            "telephone_number": "518-497-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "BREANNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle W Mulvana, CPO
• Stephanie Rose Payne, RN
• Mary Rounds, LPN
• Hannah Schack-Sehlmeyer, MA
• Monalee Mary Siskavich, SPEECH PATHOLOGIST
• Kaitlin Grace Tebo, M.S.ED, CCC-SLP
• Jessica Lynn Vanderwalker, MSOTR/L
• Lisa Whyte, PT ASSISTANT
• Joshua John Zenger, OTA

• Student in an Organized Health Care Education/Training Program in Chateaugay, NY
• Providers in Chateaugay, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.