Individual provider Active NPI

Garret Glenn Breakiron, D.C.

  • Sports Physician Chiropractor
  • Uniontown, PA
National Provider Identifier
1467508424
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC002722L Issued in PA
Practice address
665 Cherry Tree LN
Uniontown, PA 15401-8947
Phone
(724) 437-1910
Fax
(724) 437-3227
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC002722L PA Primary

Addresses

Primary practice location

665 Cherry Tree LN
Uniontown, PA 15401-8947

Mailing address

665 Cherry Tree LN
Uniontown, PA 15401-8947
Phone (724) 437-1910

Other identifiers 1

IdentifierTypeStateIssuer
00965819MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000543 PA Practitioner - Chiropractic 3476596008 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467508424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 CHERRY TREE LN",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018947",
            "telephone_number": "724-437-1910",
            "fax_number": "724-437-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 CHERRY TREE LN",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018947",
            "telephone_number": "724-437-1910",
            "fax_number": "724-437-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAKIRON",
        "first_name": "GARRET",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "PA",
            "license": "DC002722L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00965819",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.