Breedlove Wound Care of Louisiana LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BREEDLOVE WOUND CARE OF LOUISIANA LLC

Practice address

201 Gray St
Belcher, LA 71004-7729

Phone

(903) 947-2020

NPI assigned

Feb 19, 2025

Organization subpart

No

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

Authorized official

Name

Elizabeth Ann BreedloveNPI 1982844213

Title

Owner

Phone

(903) 947-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 3

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

• Adrien Ridout

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1902798408
  Medicare reassignment NPD
• Michael J Weber, MD

  • Family Medicine Physician
  • Tatum, TX
  • NPI 1679626097

  LA

  Medicare reassignment NPD
• Elizabeth Ann Breedlove, FNP

  • Family Nurse Practitioner
  • Tatum, TX
  • NPI 1982844213
  NPD (past) Authorized official

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1730984097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "TATUM",
            "state": "TX",
            "postal_code": "756911129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GRAY ST",
            "city": "BELCHER",
            "state": "LA",
            "postal_code": "710047729",
            "telephone_number": "903-947-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREEDLOVE WOUND CARE OF LOUISIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "BREEDLOVE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-947-2020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Bletz, LPC
• Gustavia Bradford
• Paige Elizabeth McDade, MCD/CCC-SLP
• Amanda Montgomery, LPC

• Family Medicine Physician in Belcher, LA
• Providers in Belcher, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.