Organization Active NPI

Steve Ewald

  • Physical Disabilities Residential Treatment Facility
  • Melbourne, FL
National Provider Identifier
1366993404
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
STEVE EWALD
Practice address
5595 Willoughby Dr
Melbourne, FL 32934-2822
Phone
(321) 505-7620
NPI assigned
Oct 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Authorized official

Name
Steve Ewald, BS/MS
Title
Ceo
Phone
(321) 505-7620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X Primary

Addresses

Primary practice location

5595 Willoughby Dr
Melbourne, FL 32934-2822

Mailing address

5595 Willoughby Dr
Melbourne, FL 32934-2822
Phone (321) 505-7620

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1366993404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5595 WILLOUGHBY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329342822",
            "telephone_number": "321-505-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5595 WILLOUGHBY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329342822",
            "telephone_number": "321-505-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE EWALD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "EWALD",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-505-7620",
        "authorized_official_credential": "BS/MS"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "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 Oct 24, 2016; 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.