Breanna Whitlock, MS, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AC001604 Issued in MD

Practice address

6420 Rockledge Dr
Suite 4100
Bethesda, MD 20817-7837

Phone

(301) 530-5151

Fax

(301) 530-7735

NPI assigned

Aug 26, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC, NY3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Champlain Valley Physicians Hospital Medical CenterGroup PAC ID 2769396878, 356 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwhitlock425641@direct.uvmhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782
  Medicare reassignment Care Compare group NPD
• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868

  DC

  Medicare reassignment NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD
• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1255359972
  NPD
• Johns Hopkins Community Physicians, Inc

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1376910331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 ROCKLEDGE DR",
            "address_2": "SUITE 4100",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177837",
            "telephone_number": "301-530-5151",
            "fax_number": "301-530-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 ROCKLEDGE DR",
            "address_2": "SUITE 4100",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177837",
            "telephone_number": "301-530-5151",
            "fax_number": "301-530-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "BREANNA",
        "credential": "MS, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC001604",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001260669",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "205443",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Jerome White Jr.
• Mathew White, CSFA
• Tara Elizabeth White, M.D.
• Katherine Myong McManus Whitehouse
• Susan Lynn Whiteway, M.D.
• Jill Whitman-Ferrario, MA, CCC-SLP
• Daniella Whitman
• Michael Christian Whitman
• Nyah Whitmire Plummer
• Rebecca H Whitmore, MSW, LGSW

• Family Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.