Vero Beach Cognitive Center LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

VERO BEACH COGNITIVE CENTER LLC

Practice address

333 17TH St Ste M
Vero Beach, FL 32960-5686

Phone

(772) 584-3083

Fax

(772) 218-3003

NPI assigned

Aug 9, 2023

Last updated

Aug 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theresa A Prescott, DO

Title

Medical Director

Phone

(772) 584-3083

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1023791738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 17TH ST STE M",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605686",
            "telephone_number": "772-584-3083",
            "fax_number": "772-218-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 17TH ST STE M",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605686",
            "telephone_number": "772-584-3083",
            "fax_number": "772-218-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERO BEACH COGNITIVE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "772-584-3083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.