Active NPI
Jane Marva Breckenridge
- Rehabilitation Psychologist
- Antlers, OK
National Provider Identifier
1942558796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- Practice address
- 112 N High St
Antlers, OK 74523-2250 - Phone
- (580) 298-3001
- Fax
- (580) 298-5357
- NPI assigned
- Aug 28, 2012
- 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 |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | Primary |
Addresses
Primary practice location
112 N High St
Antlers, OK 74523-2250
Mailing address
112 N High St
Antlers, OK 74523-2250
Phone (580) 298-3001
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": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1942558796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 N HIGH ST",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745232250",
"telephone_number": "580-298-3001",
"fax_number": "580-298-5357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 N HIGH ST",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745232250",
"telephone_number": "580-298-3001",
"fax_number": "580-298-5357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRECKENRIDGE",
"first_name": "JANE",
"middle_name": "MARVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antlers, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.