Individual provider Active NPI

Jermaine Breeden

  • Community/Behavioral Health Agency
  • Largo, MD
National Provider Identifier
1891691697
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
9500 Medical Center Dr Ste 104
Largo, MD 20774-3703
Phone
(215) 618-5256
NPI assigned
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X DC Primary

Addresses

Primary practice location

9500 Medical Center Dr Ste 104
Largo, MD 20774-3703

Mailing address

6235 Wister St
Philadelphia, PA 19138-2554
Phone (215) 618-5256

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1891691697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6235 WISTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191382554",
            "telephone_number": "215-618-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MEDICAL CENTER DR STE 104",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743703",
            "telephone_number": "215-618-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDEN",
        "first_name": "JERMAINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.