Travis Breeding, PT, MPT, NCS

Key facts

NPI

1497517700

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

38939 (CA)

Practice address

6763 County Road 19
Orland, CA 95963-9140

Phone

(530) 624-9056

NPI assigned

Jan 24, 2024

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Specialized Care Physical Therapy PC Physical Therapy Clinic/Center · Orland, CA · NPI 1043021918
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 24, 2024.

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1497517700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6763 COUNTY ROAD 19",
            "city": "ORLAND",
            "state": "CA",
            "postal_code": "959639140",
            "telephone_number": "530-624-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6763 COUNTY ROAD 19",
            "city": "ORLAND",
            "state": "CA",
            "postal_code": "959639140",
            "telephone_number": "530-624-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDING",
        "first_name": "TRAVIS",
        "credential": "PT, MPT, NCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Orland, CA · Physical Therapist in California