Organization Active NPI

Optimal Health and Wellness

  • General Practice Physician
  • Baraboo, WI
National Provider Identifier
1093309759
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMAL HEALTH AND WELLNESS
Practice address
515 South Blvd Ste C
Baraboo, WI 53913-2888
Phone
(608) 844-0496
NPI assigned
Feb 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Brandi ZimbelmanNPI 1730482258
Title
Owner/Apnp
Phone
(608) 844-0496

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

515 South Blvd Ste C
Baraboo, WI 53913-2888

Mailing address

515 South Blvd Ste C
Baraboo, WI 53913-2888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210603001165 WI Part B Supplier - Clinic/Group Practice 7517366073 Receives reassigned benefits from 4 practitioners
Practice locations: Baraboo, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2164575Optimal Health and Wellness515 S Blvd Suite C, Baraboo, WI 53913Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory

Locations

515 South Blvd
Ste C
Baraboo, WI 53913
Phone (608) 844-0496

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1093309759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SOUTH BLVD STE C",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SOUTH BLVD STE C",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132888",
            "telephone_number": "608-844-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "ZIMBELMAN",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "OWNER/APNP",
        "authorized_official_telephone_number": "608-844-0496"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.