Organization Active NPI

Optimum Health Clinics PLC

  • General Practice Physician
  • Clear Lake, IA
National Provider Identifier
1235803263
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMUM HEALTH CLINICS PLC
Practice address
506 Main Ave
Clear Lake, IA 50428-1829
Phone
(641) 357-1211
Fax
(641) 357-1213
NPI assigned
Aug 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Nick McColley
Title
Owner
Phone
(641) 357-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

506 Main Ave
Clear Lake, IA 50428-1829

Mailing address

506 Main Ave
Clear Lake, IA 50428-1829
Phone (641) 357-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210825001848 IA Part B Supplier - Clinic/Group Practice 6305241613 Receives reassigned benefits from 4 practitioners
Practice locations: Clear Lake, IA

National Provider Directory

National Provider Directory

Locations

506 Main Ave
Clear Lake, IA 50428
Phone (641) 357-1211

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1235803263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MAIN AVE",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281829",
            "telephone_number": "641-357-1211",
            "fax_number": "641-357-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MAIN AVE",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281829",
            "telephone_number": "641-357-1211",
            "fax_number": "641-357-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH CLINICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "MCCOLLEY",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-357-1211"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clear Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.