Organization Active NPI

Optimum Care Centers, LLC.

  • Multi-Specialty Clinic/Center
  • Indianapolis, IN
National Provider Identifier
1124268131
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
OPTIMUM CARE CENTERS, LLC.
Practice address
418 E 30TH St
Indianapolis, IN 46205-3909
Phone
(317) 641-2026
NPI assigned
Mar 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Dr. Chukwuemeka Kelechi Chidebelu-Eze, D.C.
Title
C.E.O.
Phone
(317) 641-2026

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NR0400X 08002356A IN
Meals Provider 174200000X
Lodging Provider 177F00000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081P2900X
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Mobile Radiology Clinic/Center 261QR0208X
Research Clinic/Center 261QR1100X
Rural Health Clinic/Center 261QR1300X
Clinical Medical Laboratory 291U00000X
Medical Foods Supplier 335G00000X

Addresses

Primary practice location

418 E 30TH St
Indianapolis, IN 46205-3909

Mailing address

3421 Lee Rd
Snellville, GA 30039-5621
Phone (317) 641-2026

Other practice location 1

3421 Lee Rd
Snellville, GA 30039-5621
Phone (317) 641-2026

National Provider Directory

National Provider Directory

Locations

418 E 30th St
Indianapolis, IN 46205
Phone (317) 641-2026

3361 N Pennsylvania St
Indianapolis, IN 46205
Phone (317) 924-9595

2625 N Meridian St
Ste 21
Indianapolis, IN 46208
Phone (317) 285-0004

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1124268131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 LEE RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300395621",
            "telephone_number": "317-641-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E 30TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053909",
            "telephone_number": "317-641-2026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3421 Lee Rd",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300395621",
            "country_code": "US",
            "telephone_number": "317-641-2026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMUM CARE CENTERS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "CHIDEBELU-EZE",
        "authorized_official_first_name": "CHUKWUEMEKA",
        "authorized_official_middle_name": "KELECHI",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "317-641-2026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IN",
            "license": "08002356A",
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335G00000X",
            "taxonomy_group": "",
            "desc": "Medical Foods Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.