Individual provider Active NPI

Briankeith Breaux

  • Psychiatric/Mental Health Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1568323798
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
211069 Issued in LA
Practice address
1800 Line Ave
Shreveport, LA 71101-4612
Phone
(318) 677-3139
NPI assigned
Nov 18, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 211069 LA Primary

Addresses

Primary practice location

1800 Line Ave
Shreveport, LA 71101-4612

Mailing address

712 Melancon St
Opelousas, LA 70570-7964
Phone (337) 308-6219

Other names 1

  • BK Breaux Other name

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

LicenseStateTypeSpecialty
211069LAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1568323798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 MELANCON ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705707964",
            "telephone_number": "337-308-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014612",
            "telephone_number": "318-677-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "BRIANKEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "211069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BK",
            "last_name": "BREAUX",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.