Organization Active NPI

Rhizome Wellness LLC

  • Primary Care Clinic/Center
  • Portland, OR
National Provider Identifier
1215528153
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
RHIZOME WELLNESS LLC
Practice address
5010 NE 33Rd Ave
Portland, OR 97211-6946
Phone
(503) 238-1065
NPI assigned
Feb 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Dr. Nicholas Becker, NDNPI 1699394411
Title
Sole Member
Phone
(301) 706-5067

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5010 NE 33Rd Ave
Portland, OR 97211-6946

Mailing address

4523 NE 82ND Ave
Portland, OR 97220-4920
Phone (301) 706-5067

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.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1215528153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4523 NE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204920",
            "telephone_number": "301-706-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116946",
            "telephone_number": "503-238-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHIZOME WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "301-706-5067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.