Simply Rooted Speech & Wellness LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SIMPLY ROOTED SPEECH & WELLNESS LLC

Practice address

1910 S Stapley Dr Ste 221
Mesa, AZ 85204-6680

Phone

(480) 573-2262

Fax

(480) 573-2169

NPI assigned

Sep 5, 2022

Organization subpart

No

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

Authorized official

Name

Heather MainNPI 1053007849

Title

Administrator, Owner

Phone

(480) 573-2262

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 3

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

• Joy Leslie, SLP

  • Speech-Language Pathologist
  • Mesa, AZ
  • NPI 1437212263
  Medicare reassignment NPD
• Heather L Main, ADMINISTRATOR, OWNER

  • Case Manager/Care Coordinator
  • Mesa, AZ
  • NPI 1053007849
  NPD Authorized official
• Ashley Jimenez, SLPA

  • Speech-Language Assistant
  • Mesa, AZ
  • NPI 1649733924
  NPD

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1265153761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10144 E CINTRON DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852129579",
            "telephone_number": "480-573-2262",
            "fax_number": "480-573-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 221",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046680",
            "telephone_number": "480-573-2262",
            "fax_number": "480-573-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 E Warner Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852963065",
            "country_code": "US",
            "telephone_number": "480-573-2262",
            "fax_number": "480-573-2169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIMPLY ROOTED SPEECH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "MAIN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "ADMINISTRATOR, OWNER",
        "authorized_official_telephone_number": "480-573-2262"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161344",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yaniv Simon, MD
• Cheryl Ann Simons, L.M.T.
• Mkayla Patrice Simons
• Simplicity Care Associates LLC
• Simply Mobile Diagnostic Imaging LLC
• Simply Serene Behavioral Health LLC (Simply Serene Wellness Center)
• Simply Serene Behavioral Health LLC (Simply Serene Wellness Center)
• Simply Serene Crisis Center LLC
• Simply Serene Detox and Recovery Center LLC
• James Simpson, MSPC, LAC

• Speech-Language Pathologist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.