NPIMap

Organization Active NPI

Optimum Mental Health Healing

  • Psychiatric/Mental Health Nurse Practitioner
  • Swansea, IL
National Provider Identifier
1265179477
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OPTIMUM MENTAL HEALTH HEALING
Practice address
208 W Pointe Dr Ste B
Swansea, IL 62226-8302
Phone
(618) 641-3588
NPI assigned
May 18, 2022
Last updated
Oct 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Brandy Eichelberger, NPNPI 1750830451
Title
Owner/Authorized Official
Phone
(618) 641-3588

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

208 W Pointe Dr Ste B
Swansea, IL 62226-8302

Mailing address

1404 Nottinghill Dr
O Fallon, IL 62269-6883
Phone (618) 641-3588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandymhnp5@optimumhealing.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214002088 IL Part B Supplier - Clinic/Group Practice 5698144608 Receives reassigned benefits from 6 practitioners
Practice locations: Swansea, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1265179477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 NOTTINGHILL DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696883",
            "telephone_number": "618-641-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W POINTE DR STE B",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268302",
            "telephone_number": "618-641-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MENTAL HEALTH HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "EICHELBERGER",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "618-641-3588",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandymhnp5@optimumhealing.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "208 W Pointe Dr Ste B",
            "city": "Swansea",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622268302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.