Organization Active NPI

Cognitive Health Centers, LLC

  • General Practice Physician
  • Sarasota, FL
National Provider Identifier
1902562663
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COGNITIVE HEALTH CENTERS, LLC
Practice address
2801 Fruitville Rd Ste 220
Sarasota, FL 34237-5397
Phone
(941) 529-0077
Fax
(941) 529-0088
NPI assigned
Nov 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Authorized official

Name
Jessie Dudley
Title
Manager
Phone
(941) 529-0077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2801 Fruitville Rd Ste 220
Sarasota, FL 34237-5397

Mailing address

2801 Fruitville Rd Ste 290
Sarasota, FL 34237-5347
Phone (941) 529-0077

Other practice location 1

4348 Southpoint Blvd Ste 310
Jacksonville, FL 32216-0934
Phone (904) 290-6028

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.greymattershealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220120000943 FL Part B Supplier - Clinic/Group Practice 7618369893 Receives reassigned benefits from 4 practitioners
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

535 Encinitas Blvd
Ste 111
Encinitas, CA 92024
Phone (760) 385-8563

Interoperability endpoints

  • Direct secure messaging: alynch@org177.direct.charmhealth.com
  • Direct secure messaging: drnields@org177.direct.charmhealth.com
  • Direct secure messaging: sspell@org177.direct.charmhealth.com

Practitioners & affiliated clinicians

Practitioners 4

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": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1902562663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 FRUITVILLE RD STE 290",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342375347",
            "telephone_number": "941-529-0077",
            "fax_number": "941-529-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FRUITVILLE RD STE 220",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342375397",
            "telephone_number": "941-529-0077",
            "fax_number": "941-529-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4348 Southpoint Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322160934",
            "country_code": "US",
            "telephone_number": "904-290-6028",
            "fax_number": "904-619-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COGNITIVE HEALTH CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-529-0077"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.greymattershealth.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2801 Fruitville Rd Ste 220",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342375397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.