Organization Active NPI

Neuropsychology and Cognitive Health

  • Clinical Neuropsychologist
  • Bellevue, WA
National Provider Identifier
1508289299
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY00002466 Issued in WA
Legal business name
NEUROPSYCHOLOGY AND COGNITIVE HEALTH
Practice address
1808 Richards Rd #120
Bellevue, WA 98005-3982
Phone
(425) 502-8341
Fax
(425) 502-8731
NPI assigned
Jan 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Jo A. Asbury
Title
Credentialing Assistant
Phone
(425) 903-3783

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X PY00002466 WA Primary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PY00002466 WA

Addresses

Primary practice location

1808 Richards Rd #120
Bellevue, WA 98005-3982

Mailing address

1808 Richards Rd #120
Bellevue, WA 98005-3982
Phone (425) 502-8341

Other identifiers 1

IdentifierTypeStateIssuer
8382822MedicaidWA

Other names 1

  • Neuropsychology and Cognitive Health, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160412001564 WA Part B Supplier - Clinic/Group Practice 0143528968 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1808 Richards Rd
Ste 113
Bellevue, WA 98005
Phone (425) 502-8341

1621 114th Ave SE
Ste 122
Bellevue, WA 98004
Phone (425) 502-8341

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1508289299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 RICHARDS RD #120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053982",
            "telephone_number": "425-502-8341",
            "fax_number": "425-502-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 RICHARDS RD #120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053982",
            "telephone_number": "425-502-8341",
            "fax_number": "425-502-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY AND COGNITIVE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "ASBURY",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "425-903-3783"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY00002466",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8382822",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuropsychology and Cognitive Health, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.