Individual provider Active NPI

Nicholas Matthew Breunig, PHYSICAL THERAPIST

  • Orthopedic Physical Therapist
  • Wahoo, NE
National Provider Identifier
1710320502
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
3154 Issued in NE
Practice address
1760 County Road J
Wahoo, NE 68066-4152
Phone
(402) 443-4191
Fax
(402) 443-1445
NPI assigned
Apr 10, 2013
Last updated
Apr 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 3154 NE
Orthopedic Physical Therapist 2251X0800X 3154 NE Primary

Addresses

Primary practice location

1760 County Road J
Wahoo, NE 68066-4152

Mailing address

1760 County Road J
Wahoo, NE 68066-4152
Phone (402) 443-4191

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
3154NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1710320502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 COUNTY ROAD J",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664152",
            "telephone_number": "402-443-4191",
            "fax_number": "402-443-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 COUNTY ROAD J",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664152",
            "telephone_number": "402-443-4191",
            "fax_number": "402-443-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREUNIG",
        "first_name": "NICHOLAS",
        "middle_name": "MATTHEW",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NE",
            "license": "3154",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NE",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.