OrganizationActive
Breakaway, LLC
NPI 1376181149 · Psychiatry Physician · Topeka, KS
Provider details
- NPI number
- 1376181149
- Entity type
- Organization
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kerry Clemetson, Director of Billing/Credentialing(913) 475-7713
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2023 Sw Gage Blvd
Topeka, KS 66604-3339
Phone: (785) 329-5344
Fax: (785) 329-5625
Approximate (ZIP-level) locationGet directions
Mailing address
2021 Vanesta Pl Ste D
Manhattan, KS 66503-0381
Registry dates
- Enumerated
- 2019-12-12
- Last updated
- 2019-12-12
- Certified
- 2019-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.