Cerebrofit LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

CEREBROFIT LLC

Practice address

2752 E Ponce de Leon Ave Ste G
Decatur, GA 30030-2714

Phone

(404) 482-3898

Fax

(404) 348-2359

NPI assigned

Apr 5, 2024

Last updated

Apr 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vonetta Dotson, PHDNPI 1912203076

Title

President

Phone

(352) 213-0100

Specialties & licenses 4

Addresses

Locations

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.

• Vonetta Michelle Dotson, PHD

  • Clinical Neuropsychologist
  • Decatur, GA
  • NPI 1912203076
  Authorized official Same address or phone

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1992558431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 E PONCE DE LEON AVE UNIT 437",
            "city": "SCOTTSDALE",
            "state": "GA",
            "postal_code": "30079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2752 E PONCE DE LEON AVE STE G",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302714",
            "telephone_number": "404-482-3898",
            "fax_number": "404-348-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBROFIT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "VONETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-213-0100",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.