Optimal Medical Associates LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

25MA03492800 Issued in NJ

Legal business name

OPTIMAL MEDICAL ASSOCIATES LLC

Practice address

1640 Route 88
Suite 203
Brick, NJ 08724-3068

Phone

(732) 814-9807

NPI assigned

Jun 16, 2014

Last updated

Jun 16, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Kipp Heacock, MD

Title

Owner

Phone

(732) 814-9807

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1235543505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 ROUTE 88",
            "address_2": "SUITE 203",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 ROUTE 88",
            "address_2": "SUITE 203",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243068",
            "telephone_number": "732-814-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "HEACOCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KIPP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-814-9807",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA03492800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.