NPIMap

Organization Active NPI

Brevard Achievement Center

  • Community/Behavioral Health Agency
  • Rockledge, FL
National Provider Identifier
1215237342
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BREVARD ACHIEVEMENT CENTER
Practice address
1845 Cogswell Street
Rockledge, FL 32955
Phone
(321) 632-8610
Fax
(321) 639-5087
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Mr. Ryan Richard Rogers
Title
Vice President, Administration
Phone
(321) 632-8610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1845 Cogswell Street
Rockledge, FL 32955

Mailing address

1845 Cogswell Street
Rockledge, FL 32955
Phone (321) 632-8610

Other identifiers 2

IdentifierTypeStateIssuer
024163601MedicaidFL
024163696MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Brevard Achievement Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1215237342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 COGSWELL STREET",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-632-8610",
            "fax_number": "321-639-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 COGSWELL STREET",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-632-8610",
            "fax_number": "321-639-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD ACHIEVEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT, ADMINISTRATION",
        "authorized_official_telephone_number": "321-632-8610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024163601",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024163696",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.