Optimal Mind Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OPTIMAL MIND PSYCHIATRY LLC

Practice address

1505 Pennsylvania Ave
McDonough, GA 30253-9114

Phone

(404) 218-8934

Fax

(678) 603-2086

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Onyebuchi Nwaokolo, DNPNPI 1639603707

Title

Ceo

Phone

(404) 218-8934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Onyebuchi Nwaokolo, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Griffin, GA
  • NPI 1639603707
  Medicare reassignment NPD Authorized official
• Judith Fuajong Ngulefac

  • Psychiatric/Mental Health Nurse Practitioner
  • Decatur, GA
  • NPI 1649787102
  Medicare reassignment NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1700567906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 WILLIAMSON RD STE 101",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245471",
            "telephone_number": "404-218-8934",
            "fax_number": "678-603-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 PENNSYLVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539114",
            "telephone_number": "404-218-8934",
            "fax_number": "678-603-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL MIND PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-30",
        "status": "A",
        "authorized_official_last_name": "NWAOKOLO",
        "authorized_official_first_name": "ONYEBUCHI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-218-8934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.