Kelly E Breen, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP5301 Issued in AZ

Practice address

3450 N 3Rd St
Phoenix, AZ 85012-2331

Phone

(602) 257-9339

Fax

(602) 285-6533

NPI assigned

Nov 7, 2013

Sex

Female

Sole proprietor

Yes

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 AZ

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connectionsaz LLCGroup PAC ID 3072858745, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Connectionsaz, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1083840953
  Medicare reassignment Care Compare group
• Connectionsaz, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1194135152
  NPD
• Connectionsaz, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1972985547
  NPD

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1851720189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W BASELINE RD APT 2142",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852835937",
            "telephone_number": "480-820-5422",
            "fax_number": "480-775-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122331",
            "telephone_number": "602-257-9339",
            "fax_number": "602-285-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEN",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP5301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence J Brecker, M.D.
• Paige Richelle Breeden
• Ruby Breeden
• Ashley Breedlove
• Jennifer Corey Breen
• Kara Jean Brei, MC, NCC, LPC
• Warren Mark Breisblatt, MD
• Stephanie Pauline Breitenbach
• Sara Jean Brekke, CCC-SLP
• Ashley Bremer, RD, CDE

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.