CASEY JO BREEDLOVE-MILLER (NPI# 1629322524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629322524 |
| Entity Type | Individual |
| Full Name | CASEY JO BREEDLOVE-MILLER |
| Credential | PA-C |
| Practice Address |
116 Hills Plz Charleston WV 25387-2438 |
| Mailing Address |
3415 Maccorkle Ave Se Charleston WV 25304-1334 |
| Practice Telephone | 3047204466 |
| Mailing Telephone | 3043888380 |
| Mailing Fax Number | 3043888395 |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2019-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 01678 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1629322524 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 97 Great Teays Blvd Ste 6, Scott Depot, WV 255609816 | 3047576999 | |
| 3415 Maccorkle Ave Se, Charleston, WV 253041334 | 3043888380 | 3043888395 |
| 116 Hills Plz, Charleston, WV 253872438 | 3047204466 |
| Street Address |
116 HILLS PLZ |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25387-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750382297 | Brian Wayne Macaulay | Family Medicine | 116 Hills Plz, Charleston, WV 25387-2438 | 2005-08-09 |
| 1033741855 | Sarah Elizabeth Shapero | Counselor | 116 Hills Plz, Charleston, WV 25387-2438 | 2020-02-10 |
| 1174164115 | Susan A Bailey | Counselor | 116 Hills Plz, Charleston, WV 25387-2438 | 2019-10-01 |
| 1659842912 | Tina L Faber | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2018-12-16 |
| 1326524323 | Hannah R Hudson | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2018-07-13 |
| 1720530074 | Rhoda Hamilton | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2016-11-02 |
| 1427502632 | Suzanne Riley | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2016-08-05 |
| 1932508413 | Elizabeth C Frampton | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2014-08-20 |
| 1912317629 | Lisa A. Kelly | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2014-05-02 |
| 1336401504 | Kasey Beth Gentilin | Dentist | 116 Hills Plz, Charleston, WV 25387-2438 | 2012-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679792493 | Letitia Elaine Tierney | Internal Medicine | Familycare Health Center, 116 N. Hills Plaza, Charleston, WV 25387 | 2007-04-24 |
| 1427661651 | James Michael Adkins | Technician | 1029 Nease Dr, Charleston, WV 25387-1007 | 2020-08-27 |
| 1578964474 | Resilience Home Care Services, LLC | Home Health | 3700 Washington St W, Charleston, WV 25387-1121 | 2014-09-10 |
| 1205448610 | Christiana E Sovine | Technician | 3902 Washington St W, Charleston, WV 25387-1123 | 2020-08-18 |
| 1245841360 | Nellie Mae Ford | Technician | 802 N Hills Dr, Charleston, WV 25387-1230 | 2020-08-12 |
| 1255941316 | Itai Gravely | Technician | 1863 Sugar Creek Dr, Charleston, WV 25387-1344 | 2020-08-04 |
| 1437513538 | Paula Mooney | Social Worker | 862 Hanna Dr, Charleston, WV 25387-1402 | 2016-04-05 |
| 1952649071 | Enact, Inc. | Case Management | 1701 5th Ave Ste 7, Charleston, WV 25387-1900 | 2013-01-24 |
| 1609045400 | Womencare, Inc | Clinic/Center | 1701 5th Ave, Charleston, WV 25387-1900 | 2008-02-26 |
| 1457967200 | Tameika M Mcneil | Technician | 113 Mcvey Way, Charleston, WV 25387-2168 | 2020-09-17 |
| Find all providers in zip 25387 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475326 | Rebecca Whealen | Physician Assistant | 2026 Huber Rd, Charleston, WV 25314-2236 | 2020-10-23 |
| 1275131054 | Ethan Brody Clontz | Physician Assistant | 1953 Pinehurst Ave, Charleston, SC 29414-6483 | 2020-10-13 |
| 1386251635 | Caitlin Estep | Physician Assistant | 3100 Maccorkle Ave Se Ste 802, Charleston, WV 25304-1233 | 2020-09-29 |
| 1487261509 | Reilly Kilpatrick | Physician Assistant | 1518 Blaze Ln, Charleston, SC 29412-8652 | 2020-09-24 |
| 1083228514 | Andrea Denise Boan | Physician Assistant | 12 Commercial Row Apt A, Charleston, SC 29412-3641 | 2020-09-02 |
| 1194343673 | Andrew N Brewer | Physician Assistant | 171 Ashley Ave Ste 419, Charleston, SC 29425-8908 | 2020-07-10 |
| 1396361309 | Jacquelyn Joseph | Physician Assistant | 134 Howard Mary Dr Apt A, Charleston, SC 29412-9581 | 2020-06-25 |
| 1639719990 | Jessy Marie Hamrick | Physician Assistant | 149 Dutch Rd Apt 105, Charleston, WV 25302-2530 | 2020-01-14 |
| 1093355521 | Virginia Noemi Escobar-cheng | Physician Assistant | 310 Red Mulberry Way Apt 3, Charleston, WV 25306-6395 | 2020-01-13 |
| 1598300279 | Breanne Marie Wiekamp | Physician Assistant | 20 Scarlet Oak Ln Apt 3, Charleston, WV 25306-1128 | 2019-11-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25387 |
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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.