Roots & Wings Community Charter School

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

000T6366 Issued in NM

Legal business name

ROOTS & WINGS COMMUNITY CHARTER SCHOOL

Practice address

35 La Lama Road
Albuquerque, NM 87556

Phone

(575) 585-2076

Fax

(575) 586-2087

NPI assigned

Nov 15, 2016

Organization subpart

No

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

Authorized official

Name

Charlotte M Archuleta

Title

Business Manager/Cpo

Phone

(505) 450-1415

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1609318112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 81, P.O. BOX 22",
            "address_2": "35 LA LAMA ROAD",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87556",
            "telephone_number": "575-585-2076",
            "fax_number": "575-586-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LA LAMA ROAD",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87556",
            "telephone_number": "575-585-2076",
            "fax_number": "575-586-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS & WINGS COMMUNITY CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "ARCHULETA",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER/CPO",
        "authorized_official_telephone_number": "505-450-1415"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NM",
            "license": "000T6366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376509448",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Root and Stem Chiropractic LLC
• Christopher William Root, MD
• Susan Root, MD
• Rooted in Wellness LLC
• Rooted Wellness Collective, LLC
• Roots of Resilience Child and Family Center LLC
• Stephen Van Roper, FNP-C, PHD
• Ivan Marie Roque, LCSW
• Janna Rorebeck, APRN-CNP
• Warren J Rorebeck, OD

• Exclusive Provider Organization in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Exclusive Provider Organization in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.