Active NPI
Susanne Breckenridge, OT
- Occupational Therapist
- Stafford, VA
National Provider Identifier
1760904072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119000435
- Practice address
- 2781 Jefferson Davis Hwy Ste 103
Stafford, VA 22554-8322 - Phone
- (540) 659-7337
- NPI assigned
- Jul 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119000435 | VA | Primary |
Addresses
Primary practice location
2781 Jefferson Davis Hwy Ste 103
Stafford, VA 22554-8322
Mailing address
2781 Jefferson Davis Hwy Ste 103
Stafford, VA 22554-8322
Phone (540) 659-7337
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0119000435 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1760904072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2781 JEFFERSON DAVIS HWY STE 103",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225548322",
"telephone_number": "540-659-7337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2781 JEFFERSON DAVIS HWY STE 103",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225548322",
"telephone_number": "540-659-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRECKENRIDGE",
"first_name": "SUSANNE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-10",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119000435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.