Optimized Wellness PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

OPTIMIZED WELLNESS PC

Practice address

39 Dorothy Dr
Troy, IL 62294-1389

Phone

(618) 530-5079

Fax

(618) 844-5021

NPI assigned

Feb 13, 2020

Last updated

Jan 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rita Ann TuckerNPI 1831566371

Title

Owner

Phone

(618) 530-5079

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Rita Tucker, N.P.

  • Family Nurse Practitioner
  • Troy, IL
  • NPI 1831566371
  Authorized official Same address or phone

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1942833363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622300055",
            "telephone_number": "618-530-5079",
            "fax_number": "618-844-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 DOROTHY DR",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941389",
            "telephone_number": "618-530-5079",
            "fax_number": "618-844-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMIZED WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-530-5079"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Moore
• Laurencyia Murdock
• Olivia Nadler
• Paige Nedrow
• New Beginnings Counseling Services, LLC
• Stefani Panicola
• Bhavesh Patel, M.D.
• Amber Pendegraft, FNP-C
• Taylor R Petrich, DMD
• Ashlynn Kaye Pinney, LCPC

• Family Nurse Practitioner in Troy, IL
• Providers in Troy, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.