Individual provider Active NPI

Kimberly Kay Breckon, O.D.

  • Optometrist
  • Falcon, CO
National Provider Identifier
1558459305
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2431 Issued in CO
Practice address
7642 McLaughlin Rd
Falcon, CO 80831
Phone
(719) 495-6611
NPI assigned
Oct 10, 2006
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2431 CO Primary

Addresses

Primary practice location

7642 McLaughlin Rd
Falcon, CO 80831

Mailing address

8101 Gilpin Peak Dr
Colorado Springs, CO 80924-4493
Phone (719) 640-3922

Other practice location 1

6901 North Academy Blvd.
Colorado Springs, CO 80918
Phone (719) 520-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040927001027 CO Practitioner - Optometry 6305815309 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2431COMDOptometrist
14481CAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arbaugh and Reuter PC Optometrist CurrentSince Jan 6, 2024 Accepting new patients
Arbaugh and Reuter PC Optometrist CurrentSince Jan 6, 2024 Accepting new patients

Locations

6091 N Academy Blvd
Colorado Springs, CO 80918
Phone (719) 520-3333

7642 McLaughlin Rd
Peyton, CO 80831
Phone (719) 495-6611

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1558459305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 GILPIN PEAK DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809244493",
            "telephone_number": "719-640-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7642 MCLAUGHLIN RD",
            "city": "FALCON",
            "state": "CO",
            "postal_code": "80831",
            "telephone_number": "719-495-6611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6901 North Academy Blvd.",
            "address_purpose": "LOCATION",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80918",
            "country_code": "US",
            "telephone_number": "719-520-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRECKON",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falcon, CO

Sources for this page

Verify at the official NPI Registry.