Organization Active NPI

Vital Roots Wellness LLC

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1538032131
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VITAL ROOTS WELLNESS LLC
Practice address
14450 Eagle Run Dr Ste 270
Omaha, NE 68116-1493
Phone
(402) 396-2935
Fax
(402) 396-2935
NPI assigned
Sep 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Robyn Anne RafterNPI 1992365001
Title
Medical Director
Phone
(402) 396-2935

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

14450 Eagle Run Dr Ste 270
Omaha, NE 68116-1493

Mailing address

14450 Eagle Run Dr Ste 270
Omaha, NE 68116-1493
Phone (402) 396-2935

Other names 1

  • ELEMENT WELLNESS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251008003102 NE Part B Supplier - Clinic/Group Practice 8426555111 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

14450 Eagle Run Dr
Ste 270
Omaha, NE 68116
Phone (402) 396-2935

Practitioners & affiliated clinicians

Practitioners 2

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": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1538032131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14450 EAGLE RUN DR STE 270",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681161493",
            "telephone_number": "402-396-2935",
            "fax_number": "402-396-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14450 EAGLE RUN DR STE 270",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681161493",
            "telephone_number": "402-396-2935",
            "fax_number": "402-396-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL ROOTS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "RAFTER",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "402-396-2935"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELEMENT WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.