Active NPI
Brook Ellen Stevens
- Vehicle Modifications Contractor
- West Melbourne, FL
National Provider Identifier
1245409291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vehicle Modifications Contractor
- Practice address
- 895 S Wickham Rd
West Melbourne, FL 32904-1648 - Phone
- (321) 768-7670
- Fax
- (321) 768-7633
- NPI assigned
- Feb 25, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vehicle Modifications Contractor | 171WV0202X | Primary | ||
| Home Modifications Contractor | 171WH0202X |
Addresses
Primary practice location
895 S Wickham Rd
West Melbourne, FL 32904-1648
Mailing address
895 S Wickham Rd
West Melbourne, FL 32904-1648
Phone (321) 768-7670
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1245409291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 S WICKHAM RD",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329041648",
"telephone_number": "321-768-7670",
"fax_number": "321-768-7633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 S WICKHAM RD",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329041648",
"telephone_number": "321-768-7670",
"fax_number": "321-768-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "BROOK",
"middle_name": "ELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-25",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "171WV0202X",
"taxonomy_group": "",
"desc": "Contractor, Vehicle Modifications",
"state": null,
"license": null,
"primary": true
},
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.