NPIMap

Organization Active NPI

Brevard Health Alliance

  • Federally Qualified Health Center (FQHC)
  • Cocoa, FL
National Provider Identifier
1952451239
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BREVARD HEALTH ALLIANCE
Practice address
15 Rosa L Jones Blvd
Cocoa, FL 32922-7899
Phone
(321) 639-5177
NPI assigned
Jan 11, 2007
Last updated
Nov 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Authorized official

Name
Marsha Vendetti
Title
Operations Manager
Phone
(321) 722-5970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

15 Rosa L Jones Blvd
Cocoa, FL 32922-7899

Mailing address

15 Rosa L Jones Blvd
Cocoa, FL 32922-7899
Phone (321) 639-5177

Other identifiers 1

IdentifierTypeStateIssuer
6886931-09MedicaidFL

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

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1952451239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ROSA L JONES BLVD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227899",
            "telephone_number": "321-639-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ROSA L JONES BLVD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227899",
            "telephone_number": "321-639-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "VENDETTI",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "321-722-5970"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6886931-09",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.