Optimal Neuroscience Services LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

OPTIMAL NEUROSCIENCE SERVICES LLC

Practice address

2775 Village PT
Chesterton, IN 46304-0099

Phone

(219) 304-6700

NPI assigned

Sep 10, 2018

Organization subpart

No

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

Authorized official

Name

Regina NelsonNPI 1679966030

Title

Ceo

Phone

(708) 369-8022

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

Enrollment records 2

Practitioners 2

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

• Regina Nelson

  • Family Nurse Practitioner
  • Merrillville, IN
  • NPI 1679966030

  IL

  Medicare reassignment NPD Authorized official
• Jervai Dumas, LCSW

  • Clinical Social Worker
  • Crown Point, IN
  • NPI 1669131249
  Medicare reassignment NPD

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1174006704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 W 65TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 VILLAGE PT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040099",
            "telephone_number": "219-304-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL NEUROSCIENCE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-369-8022"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa Jean Owen, DC
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• Psychiatry Physician in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.