DV'NN Ja'Jwan Cooks Sr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA3122 Issued in NV

Practice address

1450 N Main St
Las Vegas, NV 89101

Phone

(702) 307-4635

NPI assigned

Nov 25, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nevada Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Carson City, NV
  • NPI 1679649487

  NV

  Medicare reassignment
• Nevada Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Carson City, NV
  • NPI 1235990326
  NPD
• Nevada Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Elko, NV
  • NPI 1073690616
  NPD (past)

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1124844089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N MAIN STREET",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89101",
            "telephone_number": "702-307-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N MAIN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89101",
            "telephone_number": "702-307-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKS",
        "first_name": "DV'NN",
        "middle_name": "JA'JWAN",
        "name_suffix": "Sr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA3122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Cooks
• Chloe Kata Cooks
• Crystal Cooks
• Deborah Cooks I
• Demetrius Cooks
• Lealer Anne Cooks
• Marcus Cooks
• Trudala Jovaun Cooks
• Kieaira Cooksey
• Colby Lamar Cookson

• All providers in Las Vegas, NV
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.