Active NPI
Alan Gerard Spears
- Assisted Living Facility
- Merritt Island, FL
National Provider Identifier
1104240159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL 11441
- Practice address
- 1275 N Banana River Dr Unit 5
Merritt Island, FL 32952-5788 - Phone
- (321) 454-9528
- Fax
- (321) 454-9528
- NPI assigned
- Feb 11, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL 11441 | FL | Primary |
Addresses
Primary practice location
1275 N Banana River Dr Unit 5
Merritt Island, FL 32952-5788
Mailing address
1275 N Banana River Dr Unit 5
Merritt Island, FL 32952-5788
Phone (321) 454-9528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL 11441 | FL | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1104240159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 N BANANA RIVER DR UNIT 5",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329525788",
"telephone_number": "321-454-9528",
"fax_number": "321-454-9528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 N BANANA RIVER DR UNIT 5",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329525788",
"telephone_number": "321-454-9528",
"fax_number": "321-454-9528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARS",
"first_name": "ALAN",
"middle_name": "GERARD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-11",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "AL 11441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.