Healing Roots Medicine LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

201407546NP-PP Issued in OR

Legal business name

HEALING ROOTS MEDICINE LLC

Practice address

339 SW Century Dr Ste 201
Bend, OR 97702-1338

Phone

(541) 316-5693

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Havilah Noel BrodheadNPI 1841584844

Title

Owner

Phone

(541) 316-5693

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Hearthside Medicine Family Care Former legal business name
• Healing Roots Medicine Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27559/brand/1/csg/1/fhir/r4

Practitioners 3

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

• Havilah Noel Brodhead, R.N., MSN, FNP-BC

  • Primary Care Nurse Practitioner
  • Bend, OR
  • NPI 1841584844
  Medicare reassignment Care Compare group Authorized official
• Jeremy Brodhead, N.P.

  • Nurse Practitioner
  • Bend, OR
  • NPI 1801272513
  Medicare reassignment Care Compare group
• Marie Mency

  • Family Nurse Practitioner
  • Bend, OR
  • NPI 1932567880
  Medicare reassignment

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1477051795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 SW CENTURY DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021338",
            "telephone_number": "541-316-5693",
            "fax_number": "541-255-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 SW CENTURY DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021338",
            "telephone_number": "541-316-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING ROOTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "BRODHEAD",
        "authorized_official_first_name": "HAVILAH",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-316-5693"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "201407546NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500752671",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hearthside Medicine Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hearthside Medicine Family Care",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Healing Roots Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Healthy Roots Endodontics LLC

• Primary Care Clinic/Center in Bend, OR
• Providers in Bend, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.