Active NPI
Lori Antoinette Breaux, MD
- Pediatrics Physician
- Brentwood, TN
National Provider Identifier
1942296751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD31851
- Practice address
- 5111 Maryland Way
Suite 301
Brentwood, TN 37027-7513 - Phone
- (615) 661-4256
- Fax
- (615) 661-4253
- NPI assigned
- Sep 27, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD31851 | TN | Primary |
Addresses
Primary practice location
5111 Maryland Way
Suite 301
Brentwood, TN 37027-7513
Mailing address
5111 Maryland Way
Suite 301
Brentwood, TN 37027-7513
Phone (615) 661-4256
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3898198 | Medicaid | TN | |
| 1502886 | Medicaid | TN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD31851 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Pediatrics PLLC | Pediatrics | Past | Accepting new patients |
| Brentwood Pediatrics PLLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Brentwood, TN
- NPI 1962508937
-
- Pediatrics Physician
- Smyrna, TN
- NPI 1467781690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358812800000",
"number": "1942296751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5111 MARYLAND WAY",
"address_2": "SUITE 301",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277513",
"telephone_number": "615-661-4256",
"fax_number": "615-661-4253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5111 MARYLAND WAY",
"address_2": "SUITE 301",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277513",
"telephone_number": "615-661-4256",
"fax_number": "615-661-4253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREAUX",
"first_name": "LORI",
"middle_name": "ANTOINETTE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-27",
"last_updated": "2013-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD31851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3898198",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1502886",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.