Stacey Ann Roten, MS, NHT, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501015624 Issued in MI

Practice address

5841 Whitmore Lake Rd Ste C
Brighton, MI 48116-1991

Phone

(810) 623-9249

NPI assigned

Nov 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1023831674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10736 ODELL RD",
            "city": "FOWLERVILLE",
            "state": "MI",
            "postal_code": "488368233",
            "telephone_number": "248-835-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 WHITMORE LAKE RD STE C",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161991",
            "telephone_number": "810-623-9249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10736 ODell Rd",
            "address_purpose": "LOCATION",
            "city": "Fowlerville",
            "state": "MI",
            "postal_code": "488368233",
            "country_code": "US",
            "telephone_number": "248-835-4671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTEN",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MS, NHT, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501015624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Root
• Rooted Wellness LLC
• Roots Endodontics PLC
• Jennifer M Ross-Music, LMSW
• Sanford Samuel Ross, D.O.
• Frank Rubino
• Melissa Rudolph, MOT, OTRL
• Mary E Rupp, MD
• Adam N Rushford, DC
• Alexis Russell

• Massage Therapist in Brighton, MI
• Providers in Brighton, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.