NPIMap

Organization Active NPI

Root Therapy and Wellness

  • Multi-Specialty Clinic/Center
  • Bozeman, MT
National Provider Identifier
1194296897
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ROOT THERAPY AND WELLNESS
Practice address
1283 N 14TH Ave Ste 101
Bozeman, MT 59715-3270
Phone
(406) 219-5388
NPI assigned
Dec 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Kezia Peterson, OTNPI 1831485507
Title
Occupational Therapist/Owner
Phone
(406) 219-5388

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

1283 N 14TH Ave Ste 101
Bozeman, MT 59715-3270

Mailing address

2411 W Main St Ste 2
Bozeman, MT 59718-3815
Phone (406) 219-5388

Other practice location 1

2411 W Main St Ste 2
Bozeman, MT 59718-3815
Phone (406) 404-6147

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326003098 MT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1355681560 Receives reassigned benefits from 16 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

612 W Griffin Dr
Bozeman, MT 59715

612 W Griffin Dr
Ste A
Bozeman, MT 59715
Phone (406) 219-5388

2411 W Main St
Ste 2
Bozeman, MT 59718
Phone (406) 219-5388

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1194296897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 W MAIN ST STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183815",
            "telephone_number": "406-219-5388",
            "fax_number": "406-219-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 N 14TH AVE STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153270",
            "telephone_number": "406-219-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 W Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597183815",
            "country_code": "US",
            "telephone_number": "406-404-6147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROOT THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KEZIA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "406-219-5388",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.