Individual provider Active NPI

Robert Joseph Breen, M.D.

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1427019181
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15644 Issued in SC
Practice address
3555 Harden Street Ext Ste 141
Columbia, SC 29203-6894
Phone
(803) 434-4300
Fax
(803) 434-4351
NPI assigned
Mar 31, 2006
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 15644 SC Primary

Addresses

Primary practice location

3555 Harden Street Ext Ste 141
Columbia, SC 29203-6894

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
156440MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208000074 SC Practitioner - Psychiatry 4688630908 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 1, 2002 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 1, 2002 Accepting new patients
Prisma Health Medical Group-Midlands Psychiatry CurrentSince Apr 17, 2018 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 17, 2018 Accepting new patients
University Specialty Clinics - Neuropsychiatry and Behavioral Science Psychiatry Past Accepting new patients

Locations

1800 Colonial Dr
Columbia, SC 29203
Phone (803) 898-0123

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

3555 Harden Street Ext
Ste 141
Columbia, SC 29203
Phone (803) 434-4303

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

610 Faison Dr
Columbia, SC 29203
Phone (803) 898-8523

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1427019181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT STE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEN",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "15644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156440",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.