Organization Active NPI

Optimal Health and Wellness

  • Family Nurse Practitioner
  • Cumberland, MD
National Provider Identifier
1346925054
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
OPTIMAL HEALTH AND WELLNESS
Practice address
178 N Mechanic St
Cumberland, MD 21502-2316
Phone
(240) 580-6397
NPI assigned
Jun 20, 2023
Last updated
Jun 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Tammy Collette, CRNPNPI 1881196681
Title
FNP
Phone
(240) 580-6397

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

178 N Mechanic St
Cumberland, MD 21502-2316

Mailing address

178 N Mechanic St
Cumberland, MD 21502-2316
Phone (240) 580-6397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230822000310 MD Part B Supplier - Clinic/Group Practice 2062874100 Receives reassigned benefits from 1 practitioner
Practice locations: Cumberland, MD

National Provider Directory

National Provider Directory

Locations

178 N Mechanic St
Cumberland, MD 21502
Phone (240) 362-7033

Practitioners & affiliated clinicians

Practitioners 1

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": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1346925054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 N MECHANIC ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022316",
            "telephone_number": "240-580-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 N MECHANIC ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022316",
            "telephone_number": "240-580-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "COLLETTE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "240-580-6397",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.