Organization Active NPI

Optimal Health and Performance

  • Chiropractor
  • Upper Darby, PA
National Provider Identifier
1043826266
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OPTIMAL HEALTH AND PERFORMANCE
Practice address
7039 W Chester Pike
Upper Darby, PA 19082-1705
Phone
(484) 462-0969
NPI assigned
Sep 22, 2020
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Dr. Leo George, DCNPI 1568947760
Title
Chiropractor
Phone
(484) 462-0969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

7039 W Chester Pike
Upper Darby, PA 19082-1705

Mailing address

7039 W Chester Pike
Upper Darby, PA 19082-1705
Phone (610) 733-7551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201027000055 PA Part B Supplier - Clinic/Group Practice 2062832322 Receives reassigned benefits from 1 practitioner
Practice locations: Upper Darby, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1043826266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7039 W CHESTER PIKE",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821705",
            "telephone_number": "610-733-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7039 W CHESTER PIKE",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821705",
            "telephone_number": "484-462-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH AND PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "484-462-0969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.