Active NPI
Breckenridge Wellness Clinic
- Family Nurse Practitioner
- Flagstaff, AZ
National Provider Identifier
1659200699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Heather Breckenridge, FNP-C
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | bwc928@gmail.com | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Nurse Practitioner
- Flagstaff, AZ
- NPI 1790675262
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.