Active NPI
Alexander Ginwright
- Community Health Worker
- Palm Bay, FL
National Provider Identifier
1699049189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- OTA11458
- Practice address
- 1912 Sandia Rd SE
Palm Bay, FL 32909-5739 - Phone
- (408) 835-6974
- NPI assigned
- Feb 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | OTA11458 | FL | Primary |
Addresses
Primary practice location
1912 Sandia Rd SE
Palm Bay, FL 32909-5739
Mailing address
1912 Sadia Rd
Palm Bay, FL 32909-3769
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA11458 | FL | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1699049189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 SADIA RD",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329093769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 SANDIA RD SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329095739",
"telephone_number": "408-835-6974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GINWRIGHT",
"first_name": "ALEXANDER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-29",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "FL",
"license": "OTA11458",
"primary": true
}
],
"identifiers": [],
"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 Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.