OPTIMUM HEALTHCARE ASSOCIATES PA NPI 1891233276

NPI Information

NPI: 1891233276
Provider Name: OPTIMUM HEALTHCARE ASSOCIATES, PA

Former Legal Business Name: OPTIMUM HEALTHCARE ASSOCIATES, LLC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
5350 EXECUTIVE PL
SUITE 8
JACKSON, MS
ZIP 39206
Phone: (601) 927-1872
Get Directions

OPTIMUM HEALTHCARE ASSOCIATES, PA is a family nurse practitioner in Jackson, MS. OPTIMUM HEALTHCARE ASSOCIATES, PA NPI is 1891233276. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Optimum Healthcare Associates, Llc.

The provider's business location address is:

5350 EXECUTIVE PL
SUITE 8
JACKSON, MS
ZIP 39206-100
Phone: (601) 927-1872
Fax: (949) 607-3442

The provider's authorized official is Felisa Denise Wilson-simpson .
The authorized official title is Owner/ceo/np and has the following contact phone number (601) 397-6236.

The CLIA number assigned to this NPI record is 25D2126281 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2017 and was last updated on 11/22/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	R784445	MISSISSIPPI	Yes
2	363LP0200X	Nurse Practitioner	Pediatrics	R784445	MISSISSIPPI	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »