NPIMap

Organization Active NPI

Brevard Health Group LLC

Doing business as Brevard Spine and Rehab Institute

  • Interventional Pain Medicine Physician
  • Melbourne, FL
National Provider Identifier
1346723244
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
BREVARD HEALTH GROUP LLC
Doing business as
Brevard Spine and Rehab Institute
Practice address
1301 W Eau Gallie Blvd Ste 112
Melbourne, FL 32935
Phone
(321) 327-9788
Fax
(321) 320-7636
NPI assigned
Sep 7, 2018
Last updated
Oct 10, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
BREVARD HEALTH GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Vijay Katukuri, MDNPI 1255590261
Title
Owner
Phone
(248) 707-0920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

1301 W Eau Gallie Blvd Ste 112
Melbourne, FL 32935

Mailing address

30 Mountain Ter
Asheville, NC 28806-1924
Phone (828) 450-7064

Other names 1

  • Brevard Spine and Rehab Institute Doing business as

National Provider Directory

National Provider Directory
Part of
Brevard Health Group LLC

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20175/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1346723244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MOUNTAIN TER",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288061924",
            "telephone_number": "828-450-7064",
            "fax_number": "855-422-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 112",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-327-9788",
            "fax_number": "321-320-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD HEALTH GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREVARD HEALTH GROUP LLC",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "KATUKURI",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-707-0920",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brevard Spine and Rehab Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brevard Spine and Rehab Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 10, 2018; 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.