NPIMap

Organization Active NPI

Optima Health, PSC

  • Health Service Clinic/Center
  • Campbellsville, KY
National Provider Identifier
1306127303
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
03286 Issued in KY
Legal business name
OPTIMA HEALTH, PSC
Practice address
138 Campbellsville Byp
Suite 5
Campbellsville, KY 42718-8843
Phone
(270) 283-4638
Fax
(270) 283-4639
NPI assigned
Sep 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Authorized official

Name
Dr. Carolyn Sue Harris, DO
Title
Authorized Agent
Phone
(270) 283-4638

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 03286 KY Primary
Primary Care Clinic/Center 261QP2300X 03286 KY
Urgent Care Clinic/Center 261QU0200X 03286 KY

Addresses

Primary practice location

138 Campbellsville Byp
Suite 5
Campbellsville, KY 42718-8843

Mailing address

138 Campbellsville Byp
Suite 5
Campbellsville, KY 42718-8843
Phone (270) 283-4638

National Provider Directory

National Provider Directory

Locations

138 Campbellsville Byp
Ste 5
Campbellsvlle, KY 42718
Phone (270) 283-4368

Practitioners & affiliated clinicians

Practitioners 1

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": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1306127303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 CAMPBELLSVILLE BYP",
            "address_2": "SUITE 5",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427188843",
            "telephone_number": "270-283-4638",
            "fax_number": "270-283-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 CAMPBELLSVILLE BYP",
            "address_2": "SUITE 5",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427188843",
            "telephone_number": "270-283-4638",
            "fax_number": "270-283-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HEALTH, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "270-283-4638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "KY",
            "license": "03286",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "03286",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "KY",
            "license": "03286",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.