RICHARD J BRECKWOLDT (NPI# 1942297106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942297106 |
| Entity Type | Individual |
| Full Name | RICHARD J BRECKWOLDT |
| Credential | M.D. |
| Practice Address |
5604 Wendy Bagwell Pkwy Suite 711 Hiram GA 30141-7813 |
| Practice Telephone | 6783840800 |
| Practice Fax Number | 6783840801 |
| Mailing Telephone | 6783840800 |
| Mailing Fax Number | 6783840801 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2014-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 039295 | GA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 39295 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000656103B | 05 |
| Street Address |
5604 WENDY BAGWELL PKWY SUITE 711 |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-7813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164878302 | Synergy Homecare of Nw Atlanta | In Home Supportive Care | 5604 Wendy Bagwell Pkwy, Suite 321, Hiram, GA 30141-7813 | 2016-05-06 |
| 1891164463 | Complete Display Systems, Inc. | In Home Supportive Care | 5604 Wendy Bagwell Pkwy, Suite 811, Hiram, GA 30141-7813 | 2015-09-24 |
| 1245617364 | Pediatric Dental Specialist of Hiram | Dentist | 5604 Wendy Bagwell Pkwy, Suite 1100, Hiram, GA 30141-7813 | 2015-04-27 |
| 1336562966 | Latorey Howard | Social Worker | 5604 Wendy Bagwell Pkwy, Suite 611, Hiram, GA 30141-7813 | 2014-02-03 |
| 1548572415 | Empowered2change LLC | Social Worker | 5604 Wendy Bagwell Pkwy, Suite 812, Hiram, GA 30141-7813 | 2010-07-08 |
| 1174852156 | Sha-rhonda M. Davis | Social Worker | 5604 Wendy Bagwell Pkwy, 812, Hiram, GA 30141-7813 | 2009-12-21 |
| 1598930141 | Pinnacle Pediatrics PC | Pediatrics | 5604 Wendy Bagwell Pkwy, Suite 1111, Hiram, GA 30141-7813 | 2008-04-24 |
| 1619174463 | Andrea Battaglia | Counselor | 5604 Wendy Bagwell Pkwy, Suite 411, Hiram, GA 30141-7809 | 2007-06-27 |
| 1093911992 | John Marlin Warren | Radiologic Technologist | 5604 Wendy Bagwell Pkwy, Suite 911, Hiram, GA 30141-7809 | 2007-06-26 |
| 1376749291 | Byron T Barnes | Radiologic Technologist | 5604 Wendy Bagwell Pkwy, Hiram, GA 30141-7809 | 2007-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609022664 | Aliaksandr Dzmitryieu | Internal Medicine | 146 Bill Carruth Pkwy, Hiram, GA 30141-3749 | 2008-08-11 |
| 1891990719 | Anand S. Kenia | Internal Medicine | 144 Bill Carruth Pkwy Ste 4200, Hiram, GA 30141-3819 | 2007-06-20 |
| 1528040748 | David Gose | Internal Medicine | 176 Charles Hardy Pkwy Unit C, Hiram, GA 30141-1836 | 2005-11-15 |
| 1073514808 | Mopelola Isola | Internal Medicine | 2518 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2068 | 2005-08-02 |
| 1649686825 | Kamardeen Diekola Alabi | Internal Medicine | 2518 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2068 | 2014-07-08 |
| 1578817383 | Takele Teshi Chala | Internal Medicine | 2518 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2068 | 2012-10-31 |
| 1780940809 | Bilkisu Sulrette Gaye | Internal Medicine | 2518 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2068 | 2012-04-03 |
| 1619255882 | Rasik Parmar | Internal Medicine | 2518 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2068 | 2011-07-22 |
| 1073779625 | Hugh M. Coke IIi | Internal Medicine | 144 Bill Carruth Pkwy Ste 4200, Hiram, GA 30141 | 2008-08-04 |
| 1205051877 | Alan Chung-kee Cheng | Internal Medicine | 148 Bill Carruth Pkwy, Suite 100, Hiram, GA 30141-3754 | 2007-04-17 |
| Find all providers in HIRAM | ||||
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| 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.