Active NPI
Breck Jon Lebegue, MD MPH
- Psychiatry Physician
- Tacoma, WA
National Provider Identifier
1871571232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD60527976
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (253) 426-6691
- Fax
- (253) 426-6492
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 159944-1205 | UT | |
| Psychiatry Physician | 2084P0800X | MD60527976 | WA | Primary |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
2200 Bergquist Dr
Attn: Credentials (CMC)
Lackland a F B, TX 78236-9908
Phone (210) 292-6707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159944-1205 | UT | MD | Aerospace Medicine Physician |
| MD60527976 | WA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1871571232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR",
"address_2": "ATTN: CREDENTIALS (CMC)",
"city": "LACKLAND A F B",
"state": "TX",
"postal_code": "782369908",
"telephone_number": "210-292-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-6691",
"fax_number": "253-426-6492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBEGUE",
"first_name": "BRECK",
"middle_name": "JON",
"name_prefix": "Dr.",
"credential": "MD MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "UT",
"license": "159944-1205",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD60527976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.