Breanna Marie Payne

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0005974 Issued in CO

Practice address

373 Horse Thief LN
Durango, CO 81301-3106

Phone

(970) 759-1669

NPI assigned

Dec 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD
• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871
  Medicare reassignment
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Pueblo, CO
  • NPI 1932735321
  NPD

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1588202949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 HORSE THIEF LN",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813013106",
            "telephone_number": "970-759-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 HORSE THIEF LN",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813013106",
            "telephone_number": "970-759-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "BREANNA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyn Patrick, ND
• Matthew K. Patrick, PHARM.D.
• Patton Family Health
• Paul D Dvirnak MD PC
• Alexandar Paulson, DDS
• Peaceful Path Counseling LLC
• Peak Eyecare PLLC
• Peak Eyecare, PLLC
• Peak Labs, LLC
• Peak Physical Therapy of Durango, LLC (Peak Physical Therapy, LLC)

• Physician Assistant in Durango, CO
• Providers in Durango, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.