NPIMap

Organization Active NPI

Optimal Health: a Mind and Body Wellness Center, LLC

  • Naturopath
  • Fall River, MA
National Provider Identifier
1174006597
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
Legal business name
OPTIMAL HEALTH: A MIND AND BODY WELLNESS CENTER, LLC
Practice address
10 N Main St FL 2
Fall River, MA 02720-2130
Phone
(508) 679-9900
NPI assigned
Sep 11, 2018
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Elizabeth Gomes, LMHCNPI 1417125717
Title
Owner
Phone
(508) 245-9415

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Naturopath 175F00000X NU Primary

Addresses

Primary practice location

10 N Main St FL 2
Fall River, MA 02720-2130

Mailing address

10 N Main St FL 2
Fall River, MA 02720-2130
Phone (508) 679-9900

Other identifiers 2

IdentifierTypeStateIssuer
1992053862OtherNPI
1417125717OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241106001234 MA Part B Supplier - Clinic/Group Practice 6103350681 Receives reassigned benefits from 6 practitioners
Practice locations: Fall River, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1174006597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST FL 2",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202130",
            "telephone_number": "508-679-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST FL 2",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202130",
            "telephone_number": "508-679-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH: A MIND AND BODY WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-245-9415",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992053862",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417125717",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.