Individual provider Active NPI

Jeffrey Breckenridge, CSW

  • Clinical Social Worker
  • Provo, UT
National Provider Identifier
1649895954
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8911450 Issued in ID
Practice address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone
(476) 080-1373
Fax
(801) 373-0639
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8911450 ID Primary

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601-1677

Mailing address

743 E 1060 S
Springville, UT 84663-2867
Phone (801) 472-1082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260403001735 ID Practitioner - Clinical Social Worker 9830674100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

855 N Capital Ave
Suite 1
Idaho Falls, ID 83402-3405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8911450IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Answers, LLC CurrentSince Mar 20, 2026 Accepting new patients
Answers LLC - Peer Support PastSince Mar 20, 2026 Accepting new patients

Locations

855 N Capital Ave
Ste 1
Idaho Falls, ID 83402
Phone (208) 552-0855

755 N Main St
Ste E
Pocatello, ID 83204
Phone (208) 552-1222

Organizations & group practices 2

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1649895954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 E 1060 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632867",
            "telephone_number": "801-472-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "476-080-1373",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "JEFFREY",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8911450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.