Robert Joseph Breckenridge, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1794 Issued in OK

Practice address

401 E Oklahoma Ave
Enid, OK 73701-5800

Phone

(580) 233-4300

Fax

(580) 350-6401

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Physicians at Enid Live Well, LLP

  dba Enid Live Well

  • Chiropractor
  • Enid, OK
  • NPI 1730828112

  Acupuncturist

  NPD
• Integris Bass Baptist Health Center

  dba Integris Health Medical Group Medford

  • Rural Health Clinic/Center
  • Medford, OK
  • NPI 1730180894
  NPD (past)
• McGowan Chiroparactic Clinic, Inc.

  dba The Chiropractic

  • Chiropractor
  • Enid, OK
  • NPI 1073706024
  NPD (past)
• Viki White

  dba Resler Chiropractic

  • Chiropractor
  • Enid, OK
  • NPI 1851584197
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1790747350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E OKLAHOMA AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015800",
            "telephone_number": "580-233-4300",
            "fax_number": "580-350-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E OKLAHOMA AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015800",
            "telephone_number": "580-233-4300",
            "fax_number": "580-350-6401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 N Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737032524",
            "country_code": "US",
            "telephone_number": "580-233-4300",
            "fax_number": "580-350-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "OK",
            "license": "37D2190466",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "OK",
            "license": "37D2190466",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OK",
            "license": "1794",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "1794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110230825",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257360D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "37D2190466",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Brady
• Roselyn Marie Bramwell
• Krista B Braud, PA-C
• Jeremy Allan Bray
• Alissa Anne Braziel, M.S. CCC-SLP
• Gary Lee Breece, D.D.S., M.S.
• Tracy L. Brigham, LPC
• Idayat Brimah, MD
• Sandra G Brocar
• Brooke K Stough DPM

• Internal Medicine Physician in Enid, OK
• Providers in Enid, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.