Breedlove Wound Care of Arizona LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

BREEDLOVE WOUND CARE OF ARIZONA LLC

Practice address

2230 N Vulture Mine Rd
Wickenburg, AZ 85390-4360

Phone

(903) 947-2273

NPI assigned

Oct 22, 2025

Last updated

Oct 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Ann BreedloveNPI 1982844213

Title

Owner

Phone

(903) 947-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessea Camille Whitlow, PA-C

  • Medical Physician Assistant
  • Twin Falls, ID
  • NPI 1447652813

  AZ

  Medicare reassignment NPD
• Elizabeth Ann Breedlove, FNP

  • Family Nurse Practitioner
  • Tatum, TX
  • NPI 1982844213
  NPD (past) Authorized official

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1609743848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "TATUM",
            "state": "TX",
            "postal_code": "756911129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N VULTURE MINE RD",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853904360",
            "telephone_number": "903-947-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREEDLOVE WOUND CARE OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "BREEDLOVE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-947-2020"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Grace Bejerano, D.O.
• Darrell Allan Benham
• Robert Botbyl
• Bradshaw Mountain Diagnostic Laboratory Inc
• Jeremy J. Bramwell, DO
• Diane R Breneman, LPC
• Rita Marie Butler, MC, LPC, LISAC
• Mikaila Renae Caraveo Ruiz, PTA
• Syreeta Shawnta Carter, FNP
• Kenneth B Caton, P.A.

• Medical Physician Assistant in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.