NPIMap

Organization Active NPI

Omnis Salus, PLLC

Doing business as Omnis Health Clinic

  • Family Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1497141337
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R858548 Issued in MS
Legal business name
OMNIS SALUS, PLLC
Doing business as
Omnis Health Clinic
Practice address
7924 Highway 50 E
Columbus, MS 39702-9592
Phone
(662) 251-7389
NPI assigned
Apr 7, 2015
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Amanda FondrenNPI 1851792626
Title
Owner/Nurse Practitioner
Phone
(662) 251-7389

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 R858548 MS Primary

Addresses

Primary practice location

7924 Highway 50 E
Columbus, MS 39702-9592

Mailing address

34 Glenwood Dr.
Columbus, MS 39705
Phone (662) 570-1166

Other names 1

  • Omnis Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210507000484 MS Part B Supplier - Clinic/Group Practice 1052720851 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, MS

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24734/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1497141337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 GLENWOOD DR.",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39705",
            "telephone_number": "662-570-1166",
            "fax_number": "662-570-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7924 HIGHWAY 50 E",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397029592",
            "telephone_number": "662-251-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNIS SALUS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2021-09-16",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "FONDREN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-251-7389"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R858548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omnis Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omnis Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.