Organization Active NPI

Rooted Health Primary Care LLC

  • Adult Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1053262261
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
ROOTED HEALTH PRIMARY CARE LLC
Practice address
1101 Oakridge Dr Unit a
Fort Collins, CO 80525-5536
Phone
(970) 341-8740
Fax
(800) 927-8550
NPI assigned
Feb 4, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Lynsey MahlumNPI 1528362340
Title
Owner
Phone
(206) 913-7125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU Primary

Addresses

Primary practice location

1101 Oakridge Dr Unit a
Fort Collins, CO 80525-5536

Mailing address

1101 Oakridge Dr Unit a
Fort Collins, CO 80525-5536
Phone (970) 341-8740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260309001794 CO Part B Supplier - Clinic/Group Practice 0941783971 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1053262261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 OAKRIDGE DR UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255536",
            "telephone_number": "970-341-8740",
            "fax_number": "800-927-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OAKRIDGE DR UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255536",
            "telephone_number": "970-341-8740",
            "fax_number": "800-927-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED HEALTH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "MAHLUM",
        "authorized_official_first_name": "LYNSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-913-7125"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.