Organization Active NPI

Roots Chiropractic

  • Chiropractor
  • South Lake Tahoe, CA
National Provider Identifier
1972664712
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29850 Issued in CA
Legal business name
ROOTS CHIROPRACTIC
Practice address
3320 Sandy Way
Suite 1
South Lake Tahoe, CA 96150-8105
Phone
(530) 544-7668
NPI assigned
Dec 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bernadette Gonzales, DC
Title
Chiropractor
Phone
(530) 544-7668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29850 CA Primary

Addresses

Primary practice location

3320 Sandy Way
Suite 1
South Lake Tahoe, CA 96150-8105

Mailing address

PO Box 1589
South Lake Tahoe, CA 96156-1589
Phone (530) 544-7668

National Provider Directory

National Provider Directory

Locations

3320 Sandy Way
Ste 1
South Lake Tahoe, CA 96150
Phone (530) 541-2345

Practitioners & affiliated clinicians

Practitioners 2

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972664712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961561589",
            "telephone_number": "530-544-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 SANDY WAY",
            "address_2": "SUITE 1",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961508105",
            "telephone_number": "530-544-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "530-544-7668",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.