John William Breau Jr., R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0001143183 Issued in VA

Practice address

4213 Walney Rd
Chantilly, VA 20151-2923

Phone

(703) 502-7005

Fax

(703) 502-7055

NPI assigned

Dec 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Fairfax Falls Church Community Service Board

  • Substance Abuse Rehabilitation Facility
  • Chantilly, VA
  • NPI 1104161736
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588724066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 DANIEL TER",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012644",
            "telephone_number": "703-502-7005",
            "fax_number": "703-502-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 WALNEY RD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512923",
            "telephone_number": "703-502-7005",
            "fax_number": "703-502-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAU",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001143183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Lynn Brace, M.S.W., L.C.S.W.
• Katelyn Bragg
• Avery Brand Jakum
• Lauren A. Branly, DPT
• Elizabeth Ann Bray-Mallin
• Bright Light Consulting, LLC
• Diane Brisk
• Ajit Denis Britto, D.D.S., M.S.D.,
• Mala Ann Britto, D.D.S., M.S
• Brivana Healthcare Services LLC (Brivana health)

• Registered Nurse in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.