Organization Active NPI

Diverse Wellness Solutions

Doing business as Rooted Health Collective

  • Family Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1477347615
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DIVERSE WELLNESS SOLUTIONS
Doing business as
Rooted Health Collective
Practice address
7580 NW 5TH St Unit 15614
Plantation, FL 33318-8427
Phone
(888) 212-1949
Fax
(888) 281-6026
NPI assigned
Apr 4, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Kyndall Nyeschelle Mammah, FNPNPI 1558191726
Title
Provider/Owner
Phone
(888) 212-1949

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

7580 NW 5TH St Unit 15614
Plantation, FL 33318-8427

Mailing address

7580 NW 5TH St Unit 15614
Plantation, FL 33318-8427
Phone (888) 212-1949

Other names 1

  • Rooted Health Collective Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251204000088 FL Part B Supplier - Clinic/Group Practice 8729571120 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

National Provider Directory

National Provider Directory

Locations

7580 NW 5th St
Unit 15614
Plantation, FL 33318
Phone (888) 212-1949

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1477347615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 NW 5TH ST UNIT 15614",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333188427",
            "telephone_number": "888-212-1949",
            "fax_number": "888-281-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 NW 5TH ST UNIT 15614",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333188427",
            "telephone_number": "888-212-1949",
            "fax_number": "888-281-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE WELLNESS SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "MAMMAH",
        "authorized_official_first_name": "KYNDALL",
        "authorized_official_middle_name": "NYESCHELLE",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "888-212-1949",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rooted Health Collective",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rooted Health Collective",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.