Organization Active NPI

Optimal Health and Wellness, LLC

Doing business as Rejuvenate Health

  • General Practice Physician
  • Hilton Head, SC
National Provider Identifier
1851944532
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMAL HEALTH AND WELLNESS, LLC
Doing business as
Rejuvenate Health
Practice address
1544 Fording Island Rd
Hilton Head, SC 29926-1174
Phone
(843) 757-7836
Fax
(843) 757-7837
NPI assigned
Jul 22, 2019
Last updated
Jul 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Authorized official

Name
Dr. Bradley C Morris, DCNPI 1821032624
Title
Ceo
Phone
(843) 757-7836

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1544 Fording Island Rd
Hilton Head, SC 29926-1174

Mailing address

1544 Fording Island Rd
Hilton Head, SC 29926-1174
Phone (843) 757-7836

Other names 1

  • Rejuvenate Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200303000074 SC Part B Supplier - Clinic/Group Practice 7315374410 Receives reassigned benefits from 3 practitioners
Practice locations: Bluffton, SC

National Provider Directory

National Provider Directory

Locations

53 Persimmon St
Ste 105
Bluffton, SC 29910
Phone (843) 757-7836

1544 Fording Island Rd
Hilton Head Island, SC 29926
Phone (843) 757-7836

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": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1851944532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 FORDING ISLAND RD",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261174",
            "telephone_number": "843-757-7836",
            "fax_number": "843-757-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 FORDING ISLAND RD",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261174",
            "telephone_number": "843-757-7836",
            "fax_number": "843-757-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-757-7836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rejuvenate Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilton Head, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.