Optima Med Spa PLLC

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

Legal business name

OPTIMA MED SPA PLLC

Practice address

1950 Dodge Rd NE
Suite 106 (Inside Coldstream Health)
Cedar Rapids, IA 52402

Phone

(319) 768-7000

NPI assigned

Dec 31, 2024

Organization subpart

No

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

Authorized official

Name

Stephanie JohnsonNPI 1063338184

Title

Owner

Phone

(319) 768-7000

Specialties & licenses 1

Addresses

Other names 1

• Optima Medical Weight Loss & Wellness Doing business as

Practitioners 1

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

• Stephanie D Johnson

  • Home Health Aide
  • Cedar Rapids, IA
  • NPI 1063338184
  NPD (past) Authorized official

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741478400000",
    "number": "1376352765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 WILLIAMS BLVD SW # 2-112",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041478",
            "telephone_number": "319-573-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 DODGE RD NE",
            "address_2": "SUITE 106 (INSIDE COLDSTREAM HEALTH)",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-768-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA MED SPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-768-7000"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optima Medical Weight Loss & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optima Medical Weight Loss & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obesity and Weight Management Nutrition Registered Dietitian in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; 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.