Organization Active NPI

Wellness Roots Nexus

  • Health Service Clinic/Center
  • Springfield, MO
National Provider Identifier
1669286605
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
WELLNESS ROOTS NEXUS
Practice address
1213 S Kimbrough Ave
Springfield, MO 65807-1626
Phone
(417) 224-1401
NPI assigned
Feb 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Authorized official

Name
Jessica Lauren Maez, MS, PA-C, RDNPI 1841859709
Title
Owner, Physician Assistant
Phone
(417) 224-1401

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1213 S Kimbrough Ave
Springfield, MO 65807-1626

Mailing address

3608 W El Castile St
Springfield, MO 65807-5432

Other practice location 1

3608 W El Castile St
Springfield, MO 65807-5432
Phone (417) 224-1401

Other names 1

  • Rooted Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1738368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738368000000",
    "number": "1669286605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 W EL CASTILE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 S KIMBROUGH AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071626",
            "telephone_number": "417-224-1401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3608 W El Castile St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075432",
            "country_code": "US",
            "telephone_number": "417-224-1401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLNESS ROOTS NEXUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-01",
        "last_updated": "2025-02-01",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "MAEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "417-224-1401",
        "authorized_official_credential": "MS, PA-C, RD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rooted Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.