BREAKAWAY FUNCTIONAL MEDICINE
NPI 1780528307
Nurse Practitioner in Bismarck, ND

Q: What is Breakaway Functional Medicine's NPI number?

The NPI number for Breakaway Functional Medicine is 1780528307. It was assigned to this organization in the NPPES registry on April 15, 2026.

Q: What is Breakaway Functional Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since April 15, 2026

319 S MANDAN ST, BISMARCK, ND 58504(480) 262-0249 Get Directions Write a Review

NPPES record last updated: April 15, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Breakaway Functional Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREAKAWAY FUNCTIONAL MEDICINE (NPI 1780528307) is a healthcare organization registered as a nurse practitioner in Bismarck, North Dakota and active in the NPI registry since April 2026. The organization lists Austin Mill, Owner, as its authorized official.

NPPES Registry Identity

NPI1780528307

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameBREAKAWAY FUNCTIONAL MEDICINE

Location Address319 S MANDAN STBismarck, ND 58504-5558

Mailing Address1409 Bayview CtBismarck, ND 58504-7087 · (480) 262-0249

Phone(480) 262-0249

Organization SubpartNo

Authorized OfficialAustin MillOwner · (480) 262-0249

Enumeration DateApril 15, 2026

NPPES CertifiedApril 15, 2026

✔ NPI 1780528307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedHealth and Wellness CoachTaxonomy 171400000X

319 S MANDAN ST, Bismarck, ND 58504

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Breakaway Functional Medicine's NPI number?

The NPI number for Breakaway Functional Medicine is 1780528307. It was assigned to this organization in the NPPES registry on April 15, 2026.

Where is Breakaway Functional Medicine located?

Breakaway Functional Medicine is located at 319 S Mandan St, Bismarck, ND 58504. The listed phone number is (480) 262-0249.

What is Breakaway Functional Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Breakaway Functional Medicine was last updated on April 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.