JACKSONVILLE FAMILY HEALTH CENTER
NPI 1407943228
Clinic/Center - Primary Care in Jacksonville, AL

Active since October 05, 2006
1465 A 1ST AVE SW STE C, JACKSONVILLE, AL 36265(678) 432-4755 Get Directions Write a Review

NPPES record last updated: June 24, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacksonville Family Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSONVILLE FAMILY HEALTH CENTER (NPI 1407943228) is a healthcare organization registered as a primary care in Jacksonville, Alabama and active in the NPI registry since October 2006. The organization lists Brunda Revanna, President, as its authorized official.

NPPES Registry Identity

NPI1407943228
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBRUNDA REVANNA, MD
Location Address1465 A 1ST AVE SW STE CJacksonville, AL 36265
Mailing Address950 Eagles Landing Pkwy #321Stockbridge, GA 30281 · (678) 432-4755 · Fax (678) 432-4753
Organization SubpartNo
Authorized OfficialBrunda RevannaPresident · (678) 432-4755
Enumeration DateOctober 5, 2006
Last NPPES UpdateJune 24, 2008
NPI 1407943228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1465 A 1ST AVE SW STE C, Jacksonville, AL 36265

Other Names 1

Doing Business AsJacksonville Family Health Center

Other Identifiers 3

Medicare UPINH3509
Medicare ID-Type Unspecified051517109AL
Medicaid009930945AL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brunda Revanna, MD's NPI number?

The NPI number for Brunda Revanna, MD is 1407943228. It was assigned to this organization in the NPPES registry on October 5, 2006. The provider is doing business as Jacksonville Family Health Center.

Where is Brunda Revanna, MD located?

Brunda Revanna, MD is located at 1465 A 1st Ave SW Ste C, Jacksonville, AL 36265. The listed phone number is (678) 432-4755.

What is Brunda Revanna, MD's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Brunda Revanna, MD was last updated on June 24, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.