NPIMap

Organization Active NPI

Optima Weight & Wellness, LLC

  • Primary Care Clinic/Center
  • Edmond, OK
National Provider Identifier
1699012435
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OPTIMA WEIGHT & WELLNESS, LLC
Practice address
1489 E 15TH St
Suite 108
Edmond, OK 73013-5054
Phone
(405) 715-1919
Fax
(405) 212-5043
NPI assigned
Jan 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Jennifer Gonzales
Title
Business/HR Manager
Phone
(405) 429-5148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OK Primary

Addresses

Primary practice location

1489 E 15TH St
Suite 108
Edmond, OK 73013-5054

Mailing address

1489 E 15TH St
Suite 108
Edmond, OK 73013-5054
Phone (405) 715-1919

National Provider Directory

National Provider Directory

Locations

1489 E 15th St
Ste 108
Edmond, OK 73013
Phone (405) 715-1919

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1699012435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 E 15TH ST",
            "address_2": "SUITE 108",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135054",
            "telephone_number": "405-715-1919",
            "fax_number": "405-212-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 E 15TH ST",
            "address_2": "SUITE 108",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135054",
            "telephone_number": "405-715-1919",
            "fax_number": "405-212-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA WEIGHT & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BUSINESS/HR MANAGER",
        "authorized_official_telephone_number": "405-429-5148"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.