Breck Ardrey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8495 Issued in GA

Practice address

5461 Meridian Mark Rd Ste 570
Atlanta, GA 30342-2807

Phone

(404) 785-6895

Fax

(404) 785-6896

NPI assigned

Sep 29, 2017

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Physician Assistant

State licenses

Practice roles

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.

• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467
  NPD (past)

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1811406176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 570",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422807",
            "telephone_number": "404-785-6895",
            "fax_number": "404-785-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 570",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422807",
            "telephone_number": "404-785-6895",
            "fax_number": "404-785-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDREY",
        "first_name": "BRECK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5461 Meridian Mark Rd Ste 570",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303422807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nastasia Ardalan, MSN, NP-C, ACHPN
• Elizabeth Perry Ardell, PT
• Devarshi Rohitkumar Ardeshna, MD
• Suzanne M Ardiff, NP-C
• Carmen Ardoin, LPC
• Bryana S Ardrey, DDS
• Nahum Fekadu Arefeayne
• Feven Solomon Aregay
• Emilio Arellano
• Martha L Arellano, MD

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.