LOCAL ROOTS HEALTH CARE, PLLC NPI 1609468347

Clinic/Center (Primary Care) in Kennebunk, ME

NPI 1609468347 Organization Clinic/Center Primary Care CLIA Number 20D2214066 CLIA Certificate of Waiver

About LOCAL ROOTS HEALTH CARE, PLLC

Local Roots Health Care, Pllc is a primary care provider established in Kennebunk, Maine specializing in clinic/center (primary care) . The NPI number of Local Roots Health Care, Pllc is 1609468347 and was assigned on February 2021. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated September 2021. The authorized official of this NPI record is Kyle Anders Holmquist Fnp-c (Managing Member)

A primary care provider (PCP) like Local Roots Health Care, Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Local Roots Health Care, Pllc is 20D2214066 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Local Roots Health Care, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1609468347

Provider NameLOCAL ROOTS HEALTH CARE, PLLC
Provider Location Address12 DEPOT ST KENNEBUNK, ME 04043
Provider Mailing Address75 FOREST ST C/O KYLE HOLMQUIST SACO, ME 04072
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-04-2021
Last Update Date09-25-2021


Primary Taxonomy

Taxonomy Code261QP2300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationPrimary Care

Business Address

LOCAL ROOTS HEALTH CARE, PLLC
12 DEPOT ST
KENNEBUNK, ME
ZIP 04043
Phone: (207) 569-2021
Fax: (207) 203-4641

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Mailing Address

LOCAL ROOTS HEALTH CARE, PLLC
75 FOREST ST
C/O KYLE HOLMQUIST
SACO, ME
ZIP 04072
Phone: (207) 929-0170



Authorized Official

Authorized Official Name KYLE ANDERS HOLMQUIST FNP-C
Authorized Official TitleMANAGING MEMBER
Authorized Official Phone(207) 929-0170

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1609468347 is:

CLIA Number20D2214066
Facility TypeOTHER
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceNo

Taxonomy Description: Not Available

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1184950537 KATHLEEN ELIZABETH DIETZ LCPC
Individual
Counselor (Professional)12 DEPOT ST
KENNEBUNK, ME 04043
(207) 590-6658
1730799875 KYLE ANDERS HOLMQUIST NP-C
Individual
Nurse Practitioner (Family)12 DEPOT ST
KENNEBUNK, ME 04043
(207) 569-2021

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.