NPIMap

Organization Active NPI

Optimum Health LLC

  • Family Medicine Physician
  • Alexandria, VA
National Provider Identifier
1417723545
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTIMUM HEALTH LLC
Practice address
6354 Walker LN Ste 350
Alexandria, VA 22310-3256
Phone
(256) 425-4050
NPI assigned
Nov 29, 2023
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Allison Paige Gabbert, NPNPI 1932869724
Title
Ceo
Phone
(256) 425-4050

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 Medicine Physician 207Q00000X NU Primary
Gynecology Physician 207VG0400X NU

Addresses

Primary practice location

6354 Walker LN Ste 350
Alexandria, VA 22310-3256

Mailing address

6354 Walker LN Ste 350
Alexandria, VA 22310-3256
Phone (256) 425-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241001004296 DC Part B Supplier - Clinic/Group Practice 8921540683 Receives reassigned benefits from 7 practitioners
Practice locations: Alexandria, VA

National Provider Directory

National Provider Directory

Locations

6354 Walker Ln
Ste 303
Alexandria, VA 22310

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1417723545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6354 WALKER LN STE 350",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103256",
            "telephone_number": "256-425-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6354 WALKER LN STE 350",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103256",
            "telephone_number": "256-425-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "GABBERT",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-425-4050",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.