Organization Active NPI

Optimal T CB LLC

  • Family Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1427648955
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
OPTIMAL T CB LLC
Practice address
1030 Wright Rd Ste 3
Council Bluffs, IA 51501-8804
Phone
(712) 256-5544
NPI assigned
Jan 19, 2021
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Lori Stephens
Title
Access Manager
Phone
(712) 256-5544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

1030 Wright Rd Ste 3
Council Bluffs, IA 51501-8804

Mailing address

1030 Wright Rd Ste 3
Council Bluffs, IA 51501-8804
Phone (712) 256-5544

National Provider Directory

National Provider Directory

Locations

1030 Wright Rd
Ste 3
Council Bluffs, IA 51501
Phone (712) 256-5544

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1427648955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 WRIGHT RD STE 3",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515018804",
            "telephone_number": "712-256-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 WRIGHT RD STE 3",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515018804",
            "telephone_number": "712-256-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL T CB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "712-256-5544"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.