Optimal Wellness LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OPTIMAL WELLNESS LLC

Practice address

745 Olive Street
Suite 109
Shreveport, LA 71104

Phone

(318) 716-1200

Fax

(318) 562-3330

NPI assigned

Mar 22, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Sreedevi Yerrapragada, M.D.

Title

Officer/Manager

Phone

(318) 716-1200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1063916195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 OLIVE STREET",
            "address_2": "SUITE 109",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71104",
            "telephone_number": "318-716-1200",
            "fax_number": "318-562-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 OLIVE STREET",
            "address_2": "SUITE 109",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71104",
            "telephone_number": "318-716-1200",
            "fax_number": "318-562-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 Olive Street",
            "address_2": "Suite 109",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71104",
            "country_code": "US",
            "telephone_number": "318-716-1200",
            "fax_number": "318-562-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "YERRAPRAGADA",
        "authorized_official_first_name": "SREEDEVI",
        "authorized_official_title_or_position": "OFFICER/MANAGER",
        "authorized_official_telephone_number": "318-716-1200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.