Barry Ellis Breckle Jr., RN, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5862 Issued in MN

Practice address

1 Jefferson Barracks Dr
11G-JB
Saint Louis, MO 63125-4181

Phone

(314) 845-5054

Fax

(314) 845-5092

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

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.

• Anil Gupta M D

  • Family Medicine Physician
  • Columbia, IL
  • NPI 1699870931
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1801858121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-845-5054",
            "fax_number": "314-845-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "address_2": "11G-JB",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-845-5054",
            "fax_number": "314-845-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKLE",
        "first_name": "BARRY",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breakthrough Healthcare Limited Liability Company
• Breakthrough Healthcare Limited Liability Company
• Breakthrough in Home Service LLC
• Breathe Easy Mental Health LLC
• Tabitha Louise Brecke, PH.D., CRC
• Fritz Breckner, D.O.
• Kirsten Bredvik
• Adam J Bree, DMD
• Bradley A Breeden, M.D.
• Matthew Breeden, MD

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.