BRECKENRIDGE FAMILY CLINIC PA (NPI# 1780782672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780782672 |
| Entity Type | Organization |
| Organization Name | BRECKENRIDGE FAMILY CLINIC PA |
| Practice Address |
103 South Hartford Street Breckenridge TX 76424 |
| Practice Telephone | 2545593363 |
| Practice Fax Number | 2545591252 |
| Mailing Telephone | 2545593363 |
| Mailing Fax Number | 2545591252 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-12-12 |
| Authorized Official Name | WILLIAM ELMO PRATER (MD PRESIDENT) |
| Authorized Official Telephone | 2545593363 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G8349 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 82J127 | 01 |
| Street Address |
103 SOUTH HARTFORD STREET |
| City | BRECKENRIDGE |
| State | TX |
| Zip Code | 76424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972944833 | Clear Path Home Care LLC | In Home Supportive Care | 1515 West Walker St, Breckenridge, TX 76424 | 2013-07-08 |
| 1134565732 | Breckenridge Isd | Local Education Agency (LEA) | 206 North Miller St, Breckenridge, TX 76424 | 2013-05-22 |
| 1003063124 | Jeanene R Poston | Social Worker | 117 W Walker St., Breckenridge, TX 76424 | 2008-08-20 |
| 1841462033 | Bez Diagnostics | Clinic/Center | 151 Fm 207, Breckenridge, TX 76424 | 2008-03-27 |
| 1134249873 | Josephine Sally Kelly | Counselor | 101 E Walker St, Suite 512 & 513, Breckenridge, TX 76424 | 2007-03-29 |
| 1083623326 | Todd Martin Pennartz | Dentist | 1905 W Walker St, Breckenridge, TX 76424 | 2006-08-05 |
| 1720031321 | Stephanie Elnora Stafford | Emergency Medicine | 101 South Hartford, Breckenridge Medical Clinic, Breckenridge, TX 76424 | 2006-05-18 |
| 1205257029 | Stephens Memorial Hospital District | Medicare Defined Swing Bed Unit | 200 S Geneva St, Breckenridge, TX 76424 | 2013-12-20 |
| 1669637831 | Carol Lynn Copelin | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424 | 2008-07-27 |
| 1912114406 | Jenifer Lynn Campbell | Physical Therapist | 201 Ridge Rd, Breckenridge, TX 76424-1901 | 2007-05-16 |
| Find all providers in zip 76424 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629383 | Catholic Health Initiatives Colorado | Family Medicine | 400 N Park Ave Ste 1a, Breckenridge, CO 80424-8709 | 2020-08-11 |
| 1972811008 | Catholic Health Initiatives Colorado | Family Medicine | 555 S Park Ave, Plaza II, Breckenridge, CO 80424-0000 | 2010-09-23 |
| 1376682740 | Breckenridge Medical Clinic, LLC | Family Medicine | 555 South Park Avenue, Plaza 2, Breckenridge, CO 80424 | 2007-02-05 |
| 1871517193 | Shari J. Fitzgerald | Family Medicine | 1790 Airport Road, #b, Breckenridge, CO 80424 | 2006-07-27 |
| 1336125962 | Vladimir K Moskver | Family Medicine | 53 Audrey Cir, Breckenridge, CO 80424-8950 | 2005-12-15 |
| 1235135369 | Randall H. Nations | Family Medicine | 400 N Park Ave, # 1-a, Breckenridge, CO 80424 | 2005-06-23 |
| 1932580909 | Melinda Michelle Cusack | Family Medicine | 302 W Chestnut St, Breckenridge, MI 48615 | 2015-06-15 |
| 1104246057 | Kelli Windsor | Family Medicine | 101 S Hartford St, Breckenridge, TX 76424-4711 | 2014-04-18 |
| 1184989642 | Susan Badidi | Family Medicine | 101 S Hartford St, Breckenridge, TX 76424-4711 | 2012-07-11 |
| 1497987812 | Jennifer L. Sheffield | Family Medicine | 2400 St Francis Dr, Breckenridge, MN 56520-1025 | 2009-08-18 |
| Find all providers in BRECKENRIDGE | ||||
| City | BRECKENRIDGE |
| Zip Code | 76424 |
Please comment or provide details below to improve the information on BRECKENRIDGE FAMILY CLINIC PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.