Organization Active NPI

Rooted Wellness of Coshocton LLC

  • Primary Care Clinic/Center
  • Coshocton, OH
National Provider Identifier
1386531259
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ROOTED WELLNESS OF COSHOCTON LLC
Practice address
1101 Chestnut St
Coshocton, OH 43812-1323
Phone
(740) 294-9223
NPI assigned
Jun 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Dawn Ellen White, APRN, CNPNPI 1457864977
Title
Nurse Practitioner
Phone
(740) 294-9223

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

1101 Chestnut St
Coshocton, OH 43812-1323

Mailing address

29340 TR 338
Warsaw, OH 43844-9622
Phone (740) 294-9223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251124003466 OH Part B Supplier - Clinic/Group Practice 7517459894 Receives reassigned benefits from 1 practitioner
Practice locations: Coshocton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2328794Rooted Wellness of Coshocton, LLC1101 Chestnut St, Coshocton, OH 43812Certificate of waiverAug 17, 2027

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": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1386531259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29340 TR 338",
            "city": "WARSAW",
            "state": "OH",
            "postal_code": "438449622",
            "telephone_number": "740-294-9223",
            "fax_number": "740-294-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121323",
            "telephone_number": "740-294-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED WELLNESS OF COSHOCTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "740-294-9223",
        "authorized_official_credential": "APRN, CNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.