Root Function Wellness PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ROOT FUNCTION WELLNESS PLLC

Practice address

2320 9TH Ave SE
Watertown, SD 57201-7112

Phone

(605) 753-0920

NPI assigned

Nov 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Amy Wagoner, MDNPI 1376554568

Title

Member

Phone

(605) 880-0679

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy L Wagoner, MD

  • Family Medicine Physician
  • Watertown, SD
  • NPI 1376554568
  Medicare reassignment NPD Authorized official
• Elizabeth Wookey, CNP

  • Family Nurse Practitioner
  • Watertown, SD
  • NPI 1841136223
  NPD
• Bryan Garry Dingsor, DC

  • Chiropractor
  • Watertown, SD
  • NPI 1649200577
  NPD (past)

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1437629128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6554 9TH AVE SW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572017099",
            "telephone_number": "605-880-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 9TH AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572017112",
            "telephone_number": "605-753-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT FUNCTION WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "605-880-0679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376554568",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefanie E Roby, PA-C
• Roger L Albertson DDS PC
• Rachell M Rogge
• Lindsay K Rogness, LCSW-PIP
• Christine Ronke, BS
• Heather Anne Rorvick, MS
• Kelsey June Rose, PHARMD
• Calvin A Roseth, MD
• Ross K Schulte DDS, PC
• Nasya Roth, PT

• Primary Care Clinic/Center in Watertown, SD
• Providers in Watertown, SD by specialty
• Primary Care Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.