Organization Active NPI

Rooted Wellness Clinic

  • Chiropractor
  • San Angelo, TX
National Provider Identifier
1689459026
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ROOTED WELLNESS CLINIC
Practice address
4262 S Jackson St
San Angelo, TX 76903-9335
Phone
(325) 716-9527
NPI assigned
Aug 25, 2023
Last updated
Aug 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Dr. Melissa Jones, DCNPI 1336528066
Title
Chiropractor, Owner
Phone
(325) 716-9527

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

4262 S Jackson St
San Angelo, TX 76903-9335

Mailing address

4262 S Jackson St
San Angelo, TX 76903-9335
Phone (325) 716-9527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230920003153 TX Part B Supplier - Clinic/Group Practice 1153775481 Receives reassigned benefits from 1 practitioner
Practice locations: San Angelo, TX

National Provider Directory

National Provider Directory

Locations

4262 S Jackson St
San Angelo, TX 76903
Phone (325) 617-4172

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": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1689459026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4262 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769039335",
            "telephone_number": "325-716-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4262 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769039335",
            "telephone_number": "325-716-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CHIROPRACTOR, OWNER",
        "authorized_official_telephone_number": "325-716-9527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.