Cognitive Care PA

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

COGNITIVE CARE PA

Practice address

4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822

Phone

(904) 579-2265

NPI assigned

Aug 12, 2015

Organization subpart

No

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

Authorized official

Name

Christopher RossilliNPI 1124313879

Title

Owner

Phone

(904) 579-2265

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Christopher M Rossilli, PSYD

  • Clinical Neuropsychologist
  • Fleming Island, FL
  • NPI 1124313879
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1659747749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950-60 SAN JOSE BLVD.",
            "address_2": "SUITE 169",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-770-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 US HIGHWAY 17 STE 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034822",
            "telephone_number": "904-579-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "ROSSILLI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-579-2265"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole E Clayton, PT, DPT
• Coast Dental P.a.
• Jason Cobb
• Jalah Jy'Zaria Cobbins
• Elizabeth Coen
• Alina Coleman, DMD
• Savannah Coleman
• Brooke Alexis Collins
• Stephanie Collins
• Mary Comberiate

• Clinical Neuropsychologist in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.