Individual provider Active NPI

Jesse S Breedlove, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1992042469
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9305569 Issued in FL
Practice address
801 E 6TH St
Panama City, FL 32401-3661
Phone
(850) 785-3185
Fax
(850) 785-6233
NPI assigned
Jan 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9305569 FL Primary

Addresses

Primary practice location

801 E 6TH St
Panama City, FL 32401-3661

Mailing address

801 E 6TH St
Panama City, FL 32401-3661
Phone (850) 785-3185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130213000113 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749434140 Reassigns benefits to 6 organizations
I20140519001413 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749434140 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9305569FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Lee MD Plastic Surgery PLLC CurrentSince Aug 11, 2016 Accepting new patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2017 Accepting new patients
Sweet Dreams Nurse Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2014 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2017 Accepting new patients
Sweet Dreams Anesthesiology Nurses of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2014 Accepting new patients
Quiescence Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2016 Accepting new patients
Ias Illinois PC CurrentSince May 22, 2023 Accepting new patients
Ams of Crestview LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2017 Accepting new patients
Sweet Dreams Nurse Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 21, 2014 Accepting new patients
Aaoc Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2014 Accepting new patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2017 Accepting new patients
Atlanta Allergy & Otolaryngology Center, LLC Past Accepting new patients
Sleep and Sinus Centers ASC, LLC Past Accepting new patients

Locations

1020 E Brandon Blvd
Ste 101
Brandon, FL 33511
Phone (813) 579-3369

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

1780 N Mills Ave
Orlando, FL 32803
Phone (407) 426-8484

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

619 Pointe North Blvd
Albany, GA 31721
Phone (229) 883-4707

3243 Glynn Ave
Brunswick, GA 31520
Phone (912) 264-9029

110 Professional Ct
Jesup, GA 31545
Phone (912) 427-6029

771 Old Norcross Rd
Ste 135
Lawrenceville, GA 30046

101 McWilliams Dr
Peachtree Cty, GA 30269
Phone (678) 902-9495

1035 Southcrest Dr
Ste 250
Stockbridge, GA 30281
Phone (770) 996-9945

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

615 S Hansell St
Thomasville, GA 31792
Phone (229) 226-2234

3527 N Valdosta Rd
Ste B
Valdosta, GA 31602
Phone (229) 247-2290

4100 International Plz
Ste 800
Ft Worth, TX 76109
Phone (855) 373-6862

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIHJBA

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1992042469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "JESSE",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9305569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.