Optimum Health Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OPTIMUM HEALTH PRIMARY CARE LLC

Practice address

1878 Jeff Rd NW Ste a
Huntsville, AL 35806-4261

Phone

(256) 562-8773

NPI assigned

Feb 28, 2023

Last updated

Jul 14, 2023By 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

Elisicia JilesNPI 1518258433

Title

MD

Phone

(256) 251-5002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Elisicia Louise Taylor Jiles, M.D.

  • Family Medicine Physician
  • Huntsville, AL
  • NPI 1518258433
  Medicare reassignment Care Compare group NPD Authorized official
• Danielle Leslie Porter, FNP

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1043699937
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1316646482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 JEFF RD NW STE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064261",
            "telephone_number": "256-251-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1878 JEFF RD NW STE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064261",
            "telephone_number": "256-562-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "JILES",
        "authorized_official_first_name": "ELISICIA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "256-251-5002"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.