Individual provider Active NPI

Susan R Breeden, FNP-C

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1821412925
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18352 Issued in TN
Practice address
1905 American Way
Kingsport, TN 37660
Phone
(423) 230-8200
NPI assigned
Feb 10, 2014
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18352 TN Primary
Family Nurse Practitioner 363LF0000X 0024191647 VA

Addresses

Primary practice location

1905 American Way
Kingsport, TN 37660

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

101 Med Tech Pkwy Ste 100
Johnson City, TN 37604
Phone (423) 794-1800

Other practice location 2

16000 Johnston Memorial Dr Ste 213
Abingdon, VA 24211-0001
Phone (276) 258-2600

Other identifiers 2

IdentifierTypeStateIssuer
Q005476MedicaidTN
6010348OtherTNBCBST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140503000034 TN Practitioner - Nurse Practitioner 8628201308 Reassigns benefits to 2 organizations
I20250407003810 VA Practitioner - Nurse Practitioner 8628201308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, shared by 2 NPIs, 283 clinicians

Practice addresses (Care Compare)

16000 Johnston Mem Dr
Suite 213
Abingdon, VA 24211-7659
Phone (276) 258-2600

1905 American Way
Kingsport, TN 37660-5882
Phone (423) 578-8451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024191647VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Jun 11, 2018 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corp CurrentSince Oct 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jan 8, 2025 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Oct 1, 2024 Accepting new patients
Abingdon Physician Partners Past Accepting new patients
Takoma Regional Hospital Dba Takoma Outpatient Behavioral Services Past Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1744 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 636-8891

101 Med Tech Pkwy
Ste 100
Johnson City, TN 37604
Phone (423) 431-7626

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

1905 American Way
Kingsport, TN 37660
Phone (423) 230-8160

16000 Johnston Memorial Dr
Ste 213
Abingdon, VA 24211
Phone (276) 258-2600

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1821412925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 AMERICAN WAY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-230-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Med Tech Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37604",
            "country_code": "US",
            "telephone_number": "423-794-1800",
            "fax_number": "423-794-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr Ste 213",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242110001",
            "country_code": "US",
            "telephone_number": "276-258-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREEDEN",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18352",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024191647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005476",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "6010348",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.