Optimal Life Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

OPTIMAL LIFE CHIROPRACTIC LLC

Practice address

1051 Helmo Ave N
Oakdale, MN 55128-6032

Phone

(651) 447-8811

NPI assigned

Feb 14, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Roger Brady, DCNPI 1508499906

Title

Owner

Phone

(651) 447-8811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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

• Roger Timothy Brady, DC

  • Chiropractor
  • Oakdale, MN
  • NPI 1508499906
  Medicare reassignment Care Compare group NPD Authorized official
• Austyn Dean Wasko, DC

  • Chiropractor
  • Saint Paul, MN
  • NPI 1750044616
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1144853540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286032",
            "telephone_number": "651-447-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286032",
            "telephone_number": "651-447-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL LIFE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-447-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Charles Ohara
• Amanda Olson, MSW LICSW
• Aydarous Omar
• Opportunity Community Services Inc
• Optimal Brain MN, PLLC
• Optimized Medicine PLLC
• Khadra Osman
• Olivia Ost
• Sarah Mary-Payne Oswald, RN
• Hanan Oumer

• Chiropractor in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.