NPIMap

Organization Active NPI

Community Access to Child Health of Brevard, Inc.

  • Primary Care Clinic/Center
  • Viera, FL
National Provider Identifier
1851439608
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMMUNITY ACCESS TO CHILD HEALTH OF BREVARD, INC.
Practice address
2565 Judge Fran Jamieson Way
Viera, FL 32940-5998
Phone
(321) 637-7700
Fax
(321) 637-7707
NPI assigned
Feb 2, 2007
Last updated
Feb 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Mrs. Sharon B. Rosman, RN.NPI 1194842443
Title
Program Administrator
Phone
(321) 637-7700

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
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

2565 Judge Fran Jamieson Way
Viera, FL 32940-5998

Mailing address

2565 Judge Fran Jamieson Way
Viera, FL 32940-5998
Phone (321) 637-7700

Other identifiers 5

IdentifierTypeStateIssuer
058384700MedicaidFL
058384702MedicaidFL
885356800MedicaidFL
058384701MedicaidFL
811059000MedicaidFL

Other names 1

  • CATCH of Brevard, Inc. Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Access to Child Health of Brevard Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1851439608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329405998",
            "telephone_number": "321-637-7700",
            "fax_number": "321-637-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329405998",
            "telephone_number": "321-637-7700",
            "fax_number": "321-637-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ACCESS TO CHILD HEALTH OF BREVARD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "ROSMAN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "321-637-7700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058384700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058384702",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885356800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058384701",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811059000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CATCH of Brevard, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Viera, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; 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.