NPIMap

Organization Active NPI

Jefferson Family Corporation, Inc

Doing business as Cognisive Clinic: The Center for Brain Health

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1295397297
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JEFFERSON FAMILY CORPORATION, INC
Doing business as
Cognisive Clinic: The Center for Brain Health
Practice address
304 S. Jones Blvd
Suite #3673
Las Vegas, NV 89107
Phone
(702) 684-3573
Fax
(702) 548-6891
NPI assigned
Jul 1, 2019
Last updated
Jul 1, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
JEFFERSON FAMILY CORPORATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Authorized official

Name
Annie Mae SpencerNPI 1538426341
Title
Owner
Phone
(702) 684-3573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

304 S. Jones Blvd
Suite #3673
Las Vegas, NV 89107

Mailing address

304 S. Jones Blvd.
Suite #3673
Las Vegas, NV 89107
Phone (702) 684-3573

Other names 1

  • Cognisive Clinic: The Center for Brain Health Doing business as

National Provider Directory

National Provider Directory
Part of
Jefferson Family Corporation Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1561939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1295397297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S. JONES BLVD.",
            "address_2": "SUITE #3673",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89107",
            "telephone_number": "702-684-3573",
            "fax_number": "702-548-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S. JONES BLVD",
            "address_2": "SUITE #3673",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89107",
            "telephone_number": "702-684-3573",
            "fax_number": "702-548-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON FAMILY CORPORATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON FAMILY CORPORATION, INC",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-684-3573"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cognisive Clinic: The Center for Brain Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.