Organization Active NPI

Optimum Medical Group Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Columbia, MD
National Provider Identifier
1871472118
Registry record updated Aug 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
OPTIMUM MEDICAL GROUP INC.
Practice address
7120 Samuel Morse Dr FL 2
Columbia, MD 21046-3419
Phone
(443) 537-0012
NPI assigned
Aug 30, 2025
Organization subpart
Yes
Parent organization
OPTIMUM MEDICAL GROUP INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2025

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

Authorized official

Name
Blessing Gabriel, CRNP
Title
Ceo
Phone
(443) 537-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

7120 Samuel Morse Dr FL 2
Columbia, MD 21046-3419

Mailing address

3425 Chapman Rd
Randallstown, MD 21133-3205

National Provider Directory

National Provider Directory
Tax ID family
Optimum Medical Group Inc3 organizations share this tax ID, including this one
Part of
Optimum Medical Group Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7120 Samuel Morse Dr
Fl 2
Columbia, MD 21046
Phone (443) 537-0012

NPI Registry JSON

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

{
    "created_epoch": "1756512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756512000000",
    "number": "1871472118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 CHAPMAN RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 SAMUEL MORSE DR FL 2",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463419",
            "telephone_number": "443-537-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MEDICAL GROUP INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIMUM MEDICAL GROUP INC.",
        "enumeration_date": "2025-08-30",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "BLESSING",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-537-0012",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2025; 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.