Avian Dinah Breeding, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0059297 Issued in OK

Practice address

4149 Highline Blvd
Suite 380
Oklahoma City, OK 73108-2103

Phone

(405) 942-7650

Fax

(405) 942-7686

NPI assigned

Aug 15, 2011

Last updated

Aug 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Southern Oklahoma Treatment Services, Inc.

  • Methadone Clinic
  • Ardmore, OK
  • NPI 1083786719
  NPD (past)

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1467731976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 EDGEMERE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73071",
            "telephone_number": "405-410-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4149 HIGHLINE BLVD",
            "address_2": "SUITE 380",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731082103",
            "telephone_number": "405-942-7650",
            "fax_number": "405-942-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDING",
        "first_name": "AVIAN",
        "middle_name": "DINAH",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "0059297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200049040",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlon Breaux, M. ED.
• Candice R Breeden, PA
• Carrie Ann Breeden, PHARM D
• Cassidee Breeden
• Danie Leeann Breeden, COTA
• Erika Breedlove, MD
• Passionett Breedlove
• Deborah Breger
• Charles Ellis Brekke, MD
• David Bremer

• Licensed Practical Nurse in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.