DEEP ROOTS HEALTH CENTER INC (NPI# 1922580901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922580901 |
| Entity Type | Organization |
| Organization Name | DEEP ROOTS HEALTH CENTER INC |
| Practice Address |
103 Sw Winsted Ln Ste 25 Bentonville AR 72713-6203 |
| Practice Telephone | 4795958022 |
| Mailing Telephone | 4795958022 |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-05 |
| Authorized Official Name | DR. RYAN CARLSON (OWNER) |
| Authorized Official Telephone | 4795958022 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
103 SW WINSTED LN STE 25 |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72713-6203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477035459 | Ryan Carlson | Chiropractor | 103 Sw Winsted Ln Ste 25, Bentonville, AR 72713-6203 | 2018-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834998 | Ashley Monet Mcelroy | Chiropractor | 2303 Sw Primrose Ave, Bentonville, AR 72713 | 2018-06-08 |
| 1528544749 | Chris Tingey | Occupational Therapist | 1601 Greenhouse Rd, Bentonville, AR 72713 | 2018-07-11 |
| 1558758730 | Erik Brian Sowell | Internal Medicine | 4100 Sw I St Ste 200, Bentonville, AR 72713 | 2015-04-24 |
| 1780238782 | Chelsea D. Marquis | Nurse Practitioner | 4401 Sw Flagstone Blvd, Bentonville, AR 72713-4005 | 2019-07-29 |
| 1154921773 | Kathleen Hamblin | Pharmacist | 906 Sw Regional Airport Blvd, Bentonville, AR 72713-7364 | 2020-11-01 |
| 1245272939 | Twin Rivers Respiratory Care, Inc. | Durable Medical Equipment & Medical Supplies | 1805 Sw Regional Airport Blvd Ste 3&5, Bentonville, AR 72713-7755 | 2006-06-10 |
| 1487291415 | Rewild The Child Nwa, LLC | Occupational Therapist | 2003 Sw Regional Airport Blvd, Bentonville, AR 72713-7930 | 2019-12-10 |
| 1588276208 | Jessica Brooke Yocum | Occupational Therapy Assistant | 3902 Sw Boulder St Apt 27, Bentonville, AR 72713-8496 | 2020-08-24 |
| 1083768618 | Gregory Ryan Spears | Family Medicine | 601 Sw Regional Airport Blvd, Bentonville, AR 72713-9256 | 2007-01-22 |
| 1457716813 | Brian Daniel Melloy | Family Medicine | 601 Sw Regional Airport Blvd, Bentonville, AR 72713-9256 | 2015-12-29 |
| Find all providers in zip 72713 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306302393 | Mitchell Chiropractic Pllc | Chiropractor | 201b Ne 3rd St, Bentonville, AR 72712-5308 | 2019-02-14 |
| 1700350378 | Anthony Orlando Le | Chiropractor | 1706 Se Walton Blvd Ste 6, Bentonville, AR 72712-3201 | 2019-01-17 |
| 1356834998 | Ashley Monet Mcelroy | Chiropractor | 2303 Sw Primrose Ave, Bentonville, AR 72713 | 2018-06-08 |
| 1700330750 | Christopher Taylor Elder | Chiropractor | 1803 Sw Regional Airport Blvd Ste 9, Bentonville, AR 72712-8792 | 2016-08-08 |
| 1760837652 | Arbor Vitae Chiropractic Inc | Chiropractor | 1401 S Walton Blvd Ste 25, Bentonville, AR 72712-6139 | 2016-04-28 |
| 1902296361 | Andrew Badell | Chiropractor | 3103 N Walton Blvd Ste B, Bentonville, AR 72712-3944 | 2015-01-23 |
| 1326476888 | Justin Beagley | Chiropractor | 302 Sw 6th St Ste 12, Bentonville, AR 72712-5771 | 2013-10-21 |
| 1346686391 | Better Body Solutions Pllc | Chiropractor | 902b S Walton Blvd, Suite 18, Bentonville, AR 72712-6237 | 2013-05-17 |
| 1336428606 | Kelly Ann Goldberg | Chiropractor | 3201 Se J St, Bentonville, AR 72712 | 2011-08-04 |
| 1710293618 | Harvey James Roeder IIi | Chiropractor | 1401 Se Walton Blvd, 113, Bentonville, AR 72712-3759 | 2010-08-30 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72713 |
Please comment or provide details below to improve the information on DEEP ROOTS HEALTH CENTER INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.