NPIMap

Organization Active NPI

Roots & Resilience

  • Counselor
  • Bozeman, MT
National Provider Identifier
1992514442
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
ROOTS & RESILIENCE
Practice address
2002 N 22ND Ave Ste 1
Bozeman, MT 59718-3153
Phone
(406) 579-4984
NPI assigned
Dec 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Annie Sullivan
Title
Coo
Phone
(406) 285-1730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

2002 N 22ND Ave Ste 1
Bozeman, MT 59718-3153

Mailing address

2002 N 22ND Ave Ste 1
Bozeman, MT 59718-3153
Phone (406) 579-4984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260319001249 MT Part B Supplier - Clinic/Group Practice 0749764504 Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

2002 N 22nd Ave
Ste 1
Bozeman, MT 59718
Phone (406) 551-2306

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1992514442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N 22ND AVE STE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183153",
            "telephone_number": "406-579-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 N 22ND AVE STE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183153",
            "telephone_number": "406-579-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS & RESILIENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "406-285-1730"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.