Organization Active NPI

Breckenridge Wellness Clinic

  • Family Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1659200699
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BRECKENRIDGE WELLNESS CLINIC
Practice address
2615 N 4TH St Ste 6
Flagstaff, AZ 86004-1812
Phone
(928) 549-0730
NPI assigned
May 15, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Mrs. Heather Breckenridge, FNP-CNPI 1790675262
Title
Medical Director
Phone
(928) 589-0730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2615 N 4TH St Ste 6
Flagstaff, AZ 86004-1812

Mailing address

2615 N 4TH St Ste 6
Flagstaff, AZ 86004-1812
Phone (928) 549-0730

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL bwc928@gmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

2615 N 4th St
Ste 6
Flagstaff, AZ 86004
Phone (928) 549-0730

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1659200699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 N 4TH ST STE 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041812",
            "telephone_number": "928-549-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 N 4TH ST STE 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041812",
            "telephone_number": "928-549-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRECKENRIDGE WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "BRECKENRIDGE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "928-589-0730",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bwc928@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Healthcare inbox",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2615 N 4th St Ste 6",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860041812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.