Optimum Healthcare Associates, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R784445 Issued in MS

Legal business name

OPTIMUM HEALTHCARE ASSOCIATES, PA

Practice address

5350 Executive PL
Suite 8
Jackson, MS 39206-4100

Phone

(601) 927-1872

Fax

(949) 607-3442

NPI assigned

Feb 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Felisa Denise Wilson-Simpson, PHD, FNP-BC, PNP-BCNPI 1336177021

Title

Owner/Ceo/NP

Phone

(601) 397-6236

Specialties & licenses 2

Addresses

Other names 1

• Optimum Healthcare Associates, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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

• Felisa Denise Wilson -Simpson, CPNP, CFNP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1336177021
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1891233276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1906",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391301906",
            "telephone_number": "601-942-8447",
            "fax_number": "949-607-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 EXECUTIVE PL",
            "address_2": "SUITE 8",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064100",
            "telephone_number": "601-927-1872",
            "fax_number": "949-607-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTHCARE ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "WILSON-SIMPSON",
        "authorized_official_first_name": "FELISA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/CEO/NP",
        "authorized_official_telephone_number": "601-397-6236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, FNP-BC, PNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R784445",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R784445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Healthcare Associates, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.