Individual provider Active NPI

Breann Marie Nix

  • Student in an Organized Health Care Education/Training Program
  • Escondido, CA
National Provider Identifier
1609467539
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
91829 Issued in CA
Practice address
200 E Washington Ave
Escondido, CA 92025-1806
Phone
(760) 741-7708
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 91829 CA Primary

Addresses

Primary practice location

200 E Washington Ave
Escondido, CA 92025-1806

Mailing address

1341 N Escondido Blvd
Escondido, CA 92026-2507
Phone (760) 747-1015

Other practice location 1

1341 N Escondido Blvd
Escondido, CA 92026-2507
Phone (760) 747-1015 ext. 9865

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
91829CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthright 360 PastSince Feb 1, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1609467539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 N ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262507",
            "telephone_number": "760-747-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E WASHINGTON AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920251806",
            "telephone_number": "760-741-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 N Escondido Blvd",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920262507",
            "country_code": "US",
            "telephone_number": "760-747-1015 x9865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIX",
        "first_name": "BREANN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "91829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.