DR. CHARLES W BREAUX JR. (NPI# 1407844301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407844301 |
| Entity Type | Individual |
| Full Name | DR. CHARLES W BREAUX JR. |
| Credential | MD |
| Practice Address |
2643 Patterson Rd Suite 603 Grand Junction CO 81506-1936 |
| Practice Telephone | 9702987440 |
| Practice Fax Number | 9702987459 |
| Mailing Telephone | 9702987440 |
| Mailing Fax Number | 9702987459 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2012-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 11154 | AL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 35211 | CO | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
11154 | AL | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
35211 | CO | Allopathic & Osteopathic Physicians |
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
11154 | AL | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
35211 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 10025031 | 05 | |
| CO | BCBS PROVIDER NUMBER | BRB1426 | 01 |
| CO | 01352111 | 05 | |
| NV | 100504625 | 05 |
| Street Address |
2643 PATTERSON RD SUITE 603 |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81506-1936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323228 | Erick Renee Araneda | Internal Medicine | 2643 Patterson Rd, Suite 605, Grand Junction, CO 81506-1936 | 2005-06-02 |
| 1487196564 | Kristin Garst | Audiologist | 2643 Patterson Rd, Suite 503, Grand Junction, CO 81506-1936 | 2016-11-07 |
| 1639537145 | University Physicians Incorporated | Pediatrics | 2643 Patterson Rd, Suite 603, Grand Junction, CO 81506 | 2016-01-29 |
| 1215314745 | Missiouri D Mccoy | Nurse Practitioner | 2643 Patterson Rd, Ste 403, Grand Junction, CO 81506-1936 | 2015-05-05 |
| 1689921603 | Enrique Orellana Jr. | Internal Medicine | 2643 Patterson Rd, Suite 605, Grand Junction, CO 81506-1936 | 2012-08-08 |
| 1831464353 | Jeannette H. Sadler | Audiologist | 2643 Patterson Rd, Suite 503, Grand Junction, CO 81506 | 2012-03-16 |
| 1649557950 | Andrea Lamb | Nurse Practitioner | 2643 Patterson Rd, Suite 605, Grand Junction, CO 81506-1936 | 2011-11-15 |
| 1679852792 | Julie Mouton | Nurse Practitioner | 2643 Patterson Rd, Suite 605, Grand Junction, CO 81506-1936 | 2011-08-07 |
| 1619273547 | Colby Lee Crawford | Physician Assistant | 2643 Patterson Rd, Suite 503, Grand Junction, CO 81506-1937 | 2011-02-10 |
| 1295055077 | Shea Fetherston Chubbuck | Physician Assistant | 2643 Patterson Rd, Suite 503, Grand Junction, CO 81506 | 2010-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759820 | Dana Patton | Student in an Organized Health Care Education/Training Program | St. Mary's Family Medicine Center, 2698 Patterson Road, Grand Junction, CO 81506 | 2020-04-23 |
| 1720646292 | Creed Ott | Family Medicine | 2698 Patterson Road, Grand Junction, CO 81506 | 2019-05-30 |
| 1568948776 | Lakeside Psychological Services, LLC | Clinic/Center | 3154 Lakeside Dr Apt 103, Grand Junction, CO 81506 | 2018-07-11 |
| 1700389095 | Catherine Martha Plough | Registered Nurse | 2754 Compass Drive, Suite 377, Grand Junction, CO 81506 | 2018-03-13 |
| 1114445657 | Katrina Nicol Metcalf | Nurse Practitioner | 2643 Patterson Road Suite 605, Grand Junction, CO 81506 | 2017-09-05 |
| 1346760642 | Christopher Lewis Hoef II | Licensed Practical Nurse | 3031 N 14th St, Grand Junction, CO 81506 | 2017-06-27 |
| 1477928976 | Welbrook Senior Living Grand Junction LLC | Skilled Nursing Facility | 2596 Patterson Rd., Grand Junction, CO 81506 | 2015-12-09 |
| 1073902284 | Brett Adams | Audiologist-Hearing Aid Fitter | 2643 Patterson Rd Ste 503, Grand Junction, CO 81506 | 2015-01-12 |
| 1942625116 | Pamela W Kreps | Hearing Instrument Specialist | 759 Horizon Dr Ste E, Grand Junction, CO 81506 | 2014-02-25 |
| 1962779249 | Premere Rehab LLC | Occupational Therapist | 625 271/2 Road, Grand Junction, CO 81506 | 2011-11-30 |
| Find all providers in zip 81506 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649251836 | David Paul Bliss Jr. | Surgery | 4125 Briargate Parkway, Children's Hospital Colorado At Briargate, Colorado Springs, CO 80920 | 2005-11-07 |
| 1043825037 | Healthone Clinic Services - Pediatric Specialties LLC | Surgery | 10099 Ridgegate Pkwy Ste 100, Lone Tree, CO 80124-5532 | 2020-09-15 |
| 1689283749 | Healthone Clinic Services - Pediatric Specialties LLC | Surgery | 181 W Meadow Dr, Vail, CO 81657-5242 | 2020-07-24 |
| 1336674183 | Sarah Lai | Surgery | 2055 N High St, Suite 370, Denver, CO 80205-5503 | 2017-04-28 |
| 1942639091 | Luis Dela Torre Mondragon | Surgery | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2013-11-08 |
| 1235454125 | Shannon Nicole Acker | Surgery | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2010-04-02 |
| 1386973675 | Andrea Bischoff | Surgery | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2009-12-15 |
| 1861631244 | Stig Somme | Surgery | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2009-02-09 |
| 1952591901 | Kristin Elaine Shipman | Surgery | 2055 High Street, #370, Denver, CO 80205-5504 | 2007-07-26 |
| 1083836589 | Suzanne Yoder | Surgery | 2055 High Street, #370, Denver, CO 80205-5504 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | GRAND JUNCTION |
| Zip Code | 81506 |
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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.