Rufus G Breckenridge – Family Medicine Physician

Key facts

NPI: 1962578005
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 23745 (TN)
Practice address: 109 E Church St
Greeneville, TN 37745-5603
Phone: (423) 638-4131
Fax: (423) 638-9239
NPI assigned: Nov 28, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Holston Medical Group PC Family Medicine Physician · Kingsport, TN · NPI 1831110667

Medicare reassignment Care Compare group NPD FAMILY MEDICINE · TN

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Comprehensive Home Healthcare Services LLC Home Health Agency · Morristown, TN · NPI 1639127319

Care Compare affiliation Home health agency
Takoma Regional Hospital Inc General Acute Care Hospital · Greeneville, TN · NPI 1699819003

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Medical College of Georgia School of Medicine, 1987
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Holston Medical Group PC (239 clinicians)

Practice addresses (Care Compare)

109 E Church St
Greeneville, TN 37745-5603
Phone (423) 638-4131

Hospital & facility affiliations

Amedisys Home Health Care Home health agency · Morristown, TN · CCN 447190
Greeneville Community Hospital Hospital · Greeneville, TN · CCN 440050

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TN
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20110210000015	TN	Practitioner - Family Practice	4183725526	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Holston Medical Group PC	Family Medicine	Current since Apr 1, 2024	Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

109 E Church St
Greeneville, TN 37745
Phone (423) 638-4131

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	23745	TN	Yes

Addresses

Primary practice location

109 E Church St
Greeneville, TN 37745-5603

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

Other identifiers

Identifier	Type	State	Issuer
0000039	Medicaid	TN
2008551	Other	TN	BLUE CROSS BLUE SHIELD TN
2008551	Other	TN	BLUE CARE TN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2024.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1962578005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E CHURCH ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455603",
            "telephone_number": "423-638-4131",
            "fax_number": "423-638-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "RUFUS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "23745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000039",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "2008551",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE TN",
            "identifier": "2008551",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

All providers in Greeneville, TN · Family Medicine Physician in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.