Elizabeth Ann Breedlove, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

691969 Issued in TX

Practice address

810 N Hill St
Suite 2
Tatum, TX 75691-1740

Phone

(903) 947-2020

Fax

(903) 947-3292

NPI assigned

Feb 26, 2009

Last updated

Nov 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elizabeth Breedlove Family Practice and Aesthetics PLLCGroup PAC ID 9335293380, 3 clinicians

Breedlove Wound Care LLCGroup PAC ID 3274055694, 4 clinicians

Breedlove Wound Care of Texas LLCGroup PAC ID 3375067093, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breedlove Wound Care LLC

  • Family Nurse Practitioner
  • Tatum, TX
  • NPI 1417772997
  Medicare reassignment Care Compare group NPD Authorized official
• Breedlove Wound Care of Texas LLC

  • Family Nurse Practitioner
  • Tatum, TX
  • NPI 1841013257
  Medicare reassignment Care Compare group NPD Authorized official
• Elizabeth Breedlove Family Practice & Aesthetics PLLC

  • Family Nurse Practitioner
  • Tatum, TX
  • NPI 1356740054
  Medicare reassignment Care Compare group Authorized official
• Cherokee Quickcare LLC

  • Urgent Care Clinic/Center
  • Tatum, TX
  • NPI 1902470669

  Family

  Medicare reassignment NPD Authorized official
• Breedlove Wound Care of Arizona LLC

  • Medical Physician Assistant
  • Wickenburg, AZ
  • NPI 1609743848
  NPD (past) Authorized official
• Breedlove Wound Care of Arkansas LLC

  • Family Medicine Physician
  • Batesville, AR
  • NPI 1689569352
  NPD (past) Authorized official
• Breedlove Wound Care of Louisiana LLC

  • Family Medicine Physician
  • Belcher, LA
  • NPI 1730984097
  NPD (past) Authorized official
• Phynet, Inc.

  dba Hugman-Kent Clinic

  • Health Service Clinic/Center
  • Gladewater, TX
  • NPI 1912174111
  NPD (past)
• Breedlove Wound Care of Oklahoma LLC

  • Surgery Physician
  • Madill, OK
  • NPI 1659183135
  NPD (past)

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

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Longview Medical Center LP

  dba Longview Regional Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267
  Care Compare affiliation

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1982844213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N HILL ST",
            "address_2": "SUITE 2",
            "city": "TATUM",
            "state": "TX",
            "postal_code": "756911740",
            "telephone_number": "903-947-2020",
            "fax_number": "903-947-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N HILL ST",
            "address_2": "SUITE 2",
            "city": "TATUM",
            "state": "TX",
            "postal_code": "756911740",
            "telephone_number": "903-947-2020",
            "fax_number": "903-947-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "691969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Nicole Blassingame, LMSW
• Gwen Boykin, LVN
• Breedlove Wound Care LLC
• Breedlove Wound Care of Texas LLC
• Brookshire Brothers Inc (B and B Pharmacy)
• Careatc
• Cherokee Quickcare LLC
• Ladawn M Coleman, LVN
• Concentra Health Services Inc (Concentra Medical Compliance Administration)

• Family Nurse Practitioner in Tatum, TX
• Providers in Tatum, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.