MEDICARE: OPTICORE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1750225447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTICORE PLLC

Provider Business Mailing Address
First Line	:	6640 W WILKINSON BLVD STE 450
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-2796
Country	:	US
Telephone Number	:	855-616-0192
Fax Number	:

Provider Business Practice Location Address
First Line	:	6640 W WILKINSON BLVD STE 450
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-2796
Country	:	US
Telephone Number	:	855-616-0192
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MRS. NIMRODE N ARIDOU
Credential	:	PHMNP-BC
Telephone Number	:	855-616-0192

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	06/09/2026

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