Optimally Vibrant Health & Wellness, LLC

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

OPTIMALLY VIBRANT HEALTH & WELLNESS, LLC

Practice address

834 Sweet Birch Dr
Middletown, DE 19709-7873

Phone

(302) 376-6901

NPI assigned

Jul 16, 2021

Organization subpart

No

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

Authorized official

Name

Malaika Omowale-McQuiller, CNS, LDN

Title

Owner

Phone

(302) 314-2950

Specialties & licenses 1

Addresses

Other names 1

• Optimally Vibrant with Malaika Doing business as

Locations

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1467024554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 E MAIN ST STE 1508",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091482",
            "telephone_number": "302-314-2950",
            "fax_number": "302-378-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SWEET BIRCH DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197097873",
            "telephone_number": "302-376-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMALLY VIBRANT HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "OMOWALE-MCQUILLER",
        "authorized_official_first_name": "MALAIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-314-2950",
        "authorized_official_credential": "CNS, LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimally Vibrant with Malaika",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optimally Vibrant with Malaika",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nutritionist in Middletown, DE
• Providers in Middletown, DE by specialty
• Nutritionist in Delaware

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