Individual provider Active NPI

June Gweneth Bredin, MD

  • Family Medicine Physician
  • Ellensburg, WA
National Provider Identifier
1720127681
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00027179 Issued in WA
Practice address
521 E Mountain View Ave
Ellensburg, WA 98926-3865
Phone
(509) 962-1414
Fax
(509) 962-1408
NPI assigned
Feb 6, 2007
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00027179 WA Primary

Addresses

Primary practice location

521 E Mountain View Ave
Ellensburg, WA 98926-3865

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 494-6700

Other identifiers 2

IdentifierTypeStateIssuer
8122327MedicaidWA
1038497MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170426000288 WA Practitioner - Family Practice 0840462610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00027179WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of Central Washington Family Medicine CurrentSince Feb 4, 2019 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Jan 9, 2022 Accepting new patients
Community Health of Central Washington CurrentSince Feb 4, 2019 Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

521 E Mountain View Ave
Ellensburg, WA 98926
Phone (509) 962-1414

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1720127681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-494-6700",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263865",
            "telephone_number": "509-962-1414",
            "fax_number": "509-962-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDIN",
        "first_name": "JUNE",
        "middle_name": "GWENETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00027179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8122327",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038497",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.