Kenneth E Breeden, DO

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

OP00001987 Issued in WA

Practice address

965 Goethals Dr
Richland, WA 99352-3527

Phone

(509) 460-5588

Fax

(509) 783-5438

NPI assigned

May 19, 2006

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Kennewick Public Hospital District

  dba Kennewick General Hospital Home Health Care

  • Home Health Agency
  • Kennewick, WA
  • NPI 1184797433
  NPD (past)
• David D.Moon, D.O., LTD

  • Adult Medicine Physician
  • Las Vegas, NV
  • NPI 1932466935
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1417900309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6703 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362623",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 GOETHALS DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523527",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6703 W Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993362623",
            "country_code": "US",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREEDEN",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010299",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "OP00001987",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP00001987",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "OP00001987",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001987",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "WA",
            "license": "OP00001987",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "OP00001987",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01344361",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8434599",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009897",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn S Brault, ARNP
• Kristi Ileen Brault, ARNP
• Salud Bravo, CMA
• Christine E Bray, LMHCA
• Tanya Donna Brayer-Tymchuk, DC
• Michael Don Breier, D.M.D
• Patricia Dawn Brewster
• Brian Clemmons Counseling
• Kacey Bricker-May, CBT
• Kami Bricker

• Pain Medicine Physician in Richland, WA
• Providers in Richland, WA by specialty
• Pain Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.