Organization Active NPI

Optimus Health and Wellness Inc

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Fall River, MA
National Provider Identifier
1750035408
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
Legal business name
OPTIMUS HEALTH AND WELLNESS INC
Practice address
323 French St
Fall River, MA 02720-5441
Phone
(508) 932-0241
NPI assigned
Feb 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Kerry Taveira, APRNNPI 1447222856
Title
Owner
Phone
(508) 932-0241

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
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0808X Primary

Addresses

Primary practice location

323 French St
Fall River, MA 02720-5441

Mailing address

323 French St
Fall River, MA 02720-5441
Phone (508) 932-0241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230210000319 MA Part B Supplier - Clinic/Group Practice 7517339054 Receives reassigned benefits from 1 practitioner
Practice locations: Fall River, MA

National Provider Directory

National Provider Directory

Locations

10 Purchase St
Ste 300
Fall River, MA 02720
Phone (508) 863-1593

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1750035408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 FRENCH ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205441",
            "telephone_number": "508-932-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 FRENCH ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205441",
            "telephone_number": "508-932-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS HEALTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "TAVEIRA",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-932-0241",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.