NPIMap

Organization Active NPI

Prevent of Brevard, Inc.

  • Case Management Agency
  • Melbourne, FL
National Provider Identifier
1063440022
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
07AD751901 Issued in FL
Legal business name
PREVENT OF BREVARD, INC.
Practice address
1948 Pineapple Ave
Melbourne, FL 32935-7609
Phone
(321) 259-7262
Fax
(321) 259-7198
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kay Heimmer
Title
President Ceo
Phone
(321) 259-7262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 07AD751901 FL Primary

Addresses

Primary practice location

1948 Pineapple Ave
Melbourne, FL 32935-7609

Mailing address

1948 Pineapple Ave
Melbourne, FL 32935-7609
Phone (321) 259-7262

National Provider Directory

National Provider Directory
Tax ID family
Care Program3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1063440022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 PINEAPPLE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357609",
            "telephone_number": "321-259-7262",
            "fax_number": "321-259-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 PINEAPPLE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357609",
            "telephone_number": "321-259-7262",
            "fax_number": "321-259-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENT OF BREVARD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "HEIMMER",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "321-259-7262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "07AD751901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.