Optimal Health and Wellness Clinic, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OPTIMAL HEALTH AND WELLNESS CLINIC, PLLC

Practice address

1700 University Blvd Ste 8
Jackson, MS 39204-3907

Phone

(601) 502-4245

NPI assigned

May 25, 2022

Last updated

May 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mackinzie Lee, NPNPI 1982292926

Title

Nurse Practitioner

Phone

(601) 502-4245

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mackinzie Lee, NP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1982292926
  Authorized official Same address or phone

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1568100923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 SPRINGRIDGE RD",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391549492",
            "telephone_number": "601-502-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY BLVD STE 8",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043907",
            "telephone_number": "601-502-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH AND WELLNESS CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MACKINZIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-502-4245",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.