NPI 1376181149 · live from the CMS NPI Registry
Breakaway, LLC
Psychiatry & Neurology, Psychiatry in Topeka, KS. National Provider Identifier 1376181149, active.
NPI record
| NPI | 1376181149 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Psychiatry 2084P0800X |
| Practice location | 2023 Sw Gage Blvd, Topeka, KS 66604 |
| Practice phone | 785-329-5344 |
| Mailing address | 2021 Vanesta Pl Ste D, Manhattan, KS 66503 |
| Enumerated | December 12, 2019 |
| Last updated | December 12, 2019 |
| Authorized official | Kerry Clemetson, Director Of Billing/Credentialing |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Psychiatry primary | 2084P0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.