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

Last updated

Nov 26, 2024By the provider in NPPES

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nevada Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Carson City, NV
  • NPI 1679649487
  Medicare reassignment
• Nevada Health Centers, Inc

  dba Nevada Health Centers Mobile Medical Services 1

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

  dba Pahrump Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahrump, NV
  • NPI 1326872334
  NPD
• Nevada Health Centers Inc

  dba Elko Family Medical and Dental Center

  • 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

• Medical Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• 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.