Root & Branch Integrative Fitness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ROOT & BRANCH INTEGRATIVE FITNESS

Practice address

1235 SE Grand Ave
Portland, OR 97214-3435

Phone

(503) 577-0318

Fax

(503) 710-9221

NPI assigned

Apr 6, 2019

Organization subpart

Yes

Parent organization

ROOT & BRANCH PHYSICAL THERAPYAs reported in NPPES

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

Authorized official

Name

Alex De la Paz, PT, DPTNPI 1114350899

Title

Owner

Phone

(503) 577-0318

Specialties & licenses 1

Addresses

Part of

Root Branch Physical Thera

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Root & Branch Physical Therapy LLC

  • Physical Therapist
  • Portland, OR
  • NPI 1164899373
  NPPES parent name

Practitioners 1

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

• Alex Luis Delapaz, PT, DPT

  • Physical Therapist
  • Portland, OR
  • NPI 1114350899
  NPD Authorized official

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630195200000",
    "number": "1215490347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12575 SW DOUGLAS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972254539",
            "telephone_number": "503-577-0318",
            "fax_number": "503-710-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143435",
            "telephone_number": "503-577-0318",
            "fax_number": "503-710-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT & BRANCH INTEGRATIVE FITNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROOT & BRANCH PHYSICAL THERAPY",
        "enumeration_date": "2019-04-06",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A",
        "authorized_official_last_name": "DE LA PAZ",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-577-0318",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Roos, PT
• Mai Roost, PH.D.
• Noah Lyons Roost, PH.D.
• Root & Bloom Integrative Health
• Root & Branch
• Root & Branch Physical Therapy LLC
• Root Whole Body Health, Inc
• Root Whole Body Health, Inc
• Andrew Root, M.S.
• Daniel Bryan Root, MD

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2021; 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.