Active NPI
Carrie Boroughs Breaux, DVM DACVO
- Ophthalmology Physician
- Garden City, ID
National Provider Identifier
1437608007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- V3922
- Practice address
- 5019 N Sawyer Ave
Garden City, ID 83714 - Phone
- (208) 375-1600
- Fax
- (208) 375-1606
- NPI assigned
- Sep 23, 2016
- Last updated
- Sep 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | V3922 | ID | Primary |
Addresses
Primary practice location
5019 N Sawyer Ave
Garden City, ID 83714
Mailing address
5019 N Sawyer Ave
Garden City, ID 83714
Phone (208) 375-1600
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V3922 | ID | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1437608007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5019 N SAWYER AVE",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "83714",
"telephone_number": "208-375-1600",
"fax_number": "208-375-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5019 N SAWYER AVE",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "83714",
"telephone_number": "208-375-1600",
"fax_number": "208-375-1606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREAUX",
"first_name": "CARRIE",
"middle_name": "BOROUGHS",
"name_prefix": "Dr.",
"credential": "DVM DACVO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "ID",
"license": "V3922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.