Impact Health & Wellness LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

IMPACT HEALTH & WELLNESS LLC

Doing business as

Optimal Wellness Center

Practice address

193 E Fort Union Blvd Ste 203
Midvale, UT 84047-5543

Phone

(801) 568-1598

NPI assigned

Jul 26, 2024

Organization subpart

No

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

Authorized official

Name

Mark Monson

Title

Owner

Phone

(801) 568-1598

Specialties & licenses 2

Addresses

Other names 1

• Optimal Wellness Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce C Nielson, D.C.

  • Chiropractor
  • Midvale, UT
  • NPI 1720124761
  NPD

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1073342358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 E FORT UNION BLVD STE 203",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475543",
            "telephone_number": "801-568-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 E FORT UNION BLVD STE 203",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475543",
            "telephone_number": "801-568-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-568-1598"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimal Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Midvale, UT
• Providers in Midvale, UT by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.