Active NPI
Wellness Roots Nexus
- Health Service Clinic/Center
- Springfield, MO
National Provider Identifier
1669286605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- 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
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, RD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Springfield, MO
- NPI 1841859709
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.