Living Roots Wellness Center PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIVING ROOTS WELLNESS CENTER PLLC

Practice address

133 E Poplar Ave
Coeur D Alene, ID 83814-3435

Phone

(208) 930-4848

Fax

(844) 440-2390

NPI assigned

Aug 5, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Melissa Anne Jacobson, DCNPI 1801117841

Title

Owner/Chiropractor

Phone

(208) 930-4848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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

• Melissa A Jacobson, DC

  • Chiropractor
  • Coeur D Alene, ID
  • NPI 1801117841
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1235866575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E POPLAR AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143435",
            "telephone_number": "208-930-4848",
            "fax_number": "844-440-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E POPLAR AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143435",
            "telephone_number": "208-930-4848",
            "fax_number": "844-440-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING ROOTS WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "208-930-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Lish
• Madison Lish, LPC
• Ashley N Lisk, LPC
• Amy Lynn Little, PHARM D
• Frank Liu, PHARMD
• Living Waters Coordinated Communities, Inc.
• Lanette Gay Livingston-Clark, M.ED LPC
• Andrea S Livingston, PHARM.D.
• Megan Livingston
• Lloyd E. Witham MD PA

• Chiropractor in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.