NPIMap

Organization Active NPI

Brevard Health Alliance Inc

  • Family Medicine Physician
  • Palm Bay, FL
National Provider Identifier
1679622120
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BREVARD HEALTH ALLIANCE INC
Practice address
5270 Babcock St NE # ST1
Palm Bay, FL 32905-8630
Phone
(321) 722-5959
NPI assigned
Jan 10, 2007
Last updated
Jun 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Angela Craig
Title
Director
Phone
(321) 241-6800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

5270 Babcock St NE # ST1
Palm Bay, FL 32905-8630

Mailing address

5270 Babcock St NE # ST1
Palm Bay, FL 32905-8630
Phone (321) 722-5959

Other identifiers 1

IdentifierTypeStateIssuer
6886931-01MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Brevard Health Alliance42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1679622120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5270 BABCOCK ST NE # ST1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329058630",
            "telephone_number": "321-722-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 BABCOCK ST NE # ST1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329058630",
            "telephone_number": "321-722-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD HEALTH ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "321-241-6800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6886931-01",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.