Individual provider Active NPI

Marcia Reed Flugsrud-Breckenridge, MD,PHD

  • Child & Adolescent Psychiatry Physician
  • Fort Riley, KS
National Provider Identifier
1396766317
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME45457 Issued in FL
Practice address
Iach
650 Heubner Rd
Fort Riley, KS 66442-5808
Phone
(386) 755-3016
Fax
(386) 758-3212
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME45457 FL
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X ME45457 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME45457 FL Primary

Addresses

Primary practice location

Iach
650 Heubner Rd
Fort Riley, KS 66442-5808

Mailing address

600 Heubner Road
Fort Riley, KS 66442
Phone (785) 239-7581

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)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ME45457FLMDPain Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1396766317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HEUBNER ROAD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "66442",
            "telephone_number": "785-239-7581",
            "fax_number": "785-240-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IACH",
            "address_2": "650 HEUBNER RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664425808",
            "telephone_number": "386-755-3016",
            "fax_number": "386-758-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUGSRUD-BRECKENRIDGE",
        "first_name": "MARCIA",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2021-11-12",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME45457",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "FL",
            "license": "ME45457",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME45457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Riley, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.