NPIMap

Organization Active NPI

Optimae Lifeservices, Inc,

  • Community/Behavioral Health Agency
  • Fairfield, IA
National Provider Identifier
1174520084
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OPTIMAE LIFESERVICES, INC,
Practice address
301 W Burlington Ave
Fairfield, IA 52556-3242
Phone
(641) 472-5771
Fax
(641) 472-1817
NPI assigned
Jul 7, 2005
Last updated
Jul 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Authorized official

Name
Ms. Nancy Lynn McStockard
Title
Director of Billing
Phone
(641) 472-1684

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 03816 IA
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

301 W Burlington Ave
Fairfield, IA 52556-3242

Mailing address

301 W Burlington Ave
Fairfield, IA 52556-3242
Phone (641) 472-1684

Other identifiers 2

IdentifierTypeStateIssuer
0272021MedicaidIA
58181OtherIABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000270 IA Part B Supplier - Clinic/Group Practice 8022912211 Receives reassigned benefits from 37 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianola, IA; Iowa City, IA; Keokuk, IA; Keosauqua, IA; Knoxville, IA; Marshalltown, IA; Mount Pleasant, IA; Newton, IA…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 36)

401 Visions Pkwy
Adel, IA 50003

401 Visions Pkwy
Ste A
Adel, IA 50003
Phone (515) 243-3525

213 Duff Ave
Ste 1
Ames, IA 50010
Phone (515) 715-1887

213 Duff Ave
Ste I
Ames, IA 50010

712 S West St
Bloomfield, IA 52537

712 S West St
Ste 3
Bloomfield, IA 52537
Phone (641) 472-5771

825 N 6th St
Ste 6
Burlington, IA 52601
Phone (319) 237-1732

883 Shaver Rd NE
Ste E
Cedar Rapids, IA 52402
Phone (319) 591-8111

209 E Maple St
Ste 8
Centerville, IA 52544
Phone (641) 682-4804

1711 Osceola Ave
Ste 104
Chariton, IA 50049
Phone (641) 472-5771

2600 Grand Ave
Des Moines, IA 50312
Phone (515) 243-3525

602 E Grand Ave
Des Moines, IA 50309
Phone (515) 243-0815

1514 Edgington Ave
Eldora, IA 50627
Phone (515) 715-1887

1930 250th St
Fairfield, IA 52556
Phone (515) 693-4541

2201 W Jefferson Ave
Fairfield, IA 52556
Phone (641) 472-4464

51 W Washington Ave
Ste A
Fairfield, IA 52556
Phone (641) 472-5771

1809 W 2nd Ave
Ste 1807
Indianola, IA 50125
Phone (515) 962-5485

1809 W 2nd Ave
Ste 1809
Indianola, IA 50125

1121 Shirken Dr
Iowa City, IA 52246
Phone (641) 472-5771

2460 Towncrest Dr
Ste 1
Iowa City, IA 52240
Phone (319) 337-2008

3882 Main St
Ste 1
Keokuk, IA 52632
Phone (319) 524-5106

204 E Robinson St
Knoxville, IA 50138
Phone (641) 205-8501

101 E Southridge Rd
Marshalltown, IA 50158
Phone (641) 351-4447

605 E Winfield Ave
Mt Pleasant, IA 52641
Phone (319) 385-8051

605 E Winfield Ave
Ste 200
Mt Pleasant, IA 52641

Practitioners & affiliated clinicians

Practitioners 111

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.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1174520084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BURLINGTON AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525563242",
            "telephone_number": "641-472-1684",
            "fax_number": "641-472-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BURLINGTON AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525563242",
            "telephone_number": "641-472-5771",
            "fax_number": "641-472-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAE LIFESERVICES, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "MCSTOCKARD",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "641-472-1684",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "03816",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0272021",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58181",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.