RADICAL ROOTS CLINIC LLC
NPI 1629737150
Nurse Practitioner in Arthur, IL

Q: What is Radical Roots Clinic LLC's NPI number?

The NPI number for Radical Roots Clinic LLC is 1629737150. It was assigned to this organization in the NPPES registry on December 13, 2021.

Q: What is Radical Roots Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since December 13, 2021

2046 JONATHAN CREEK RD, ARTHUR, IL 61911(765) 267-1177 Get Directions Write a Review

NPPES record last updated: May 30, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 27, 2022, Dec 13, 2021 (2 updates tracked since 2021).

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About Radical Roots Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RADICAL ROOTS CLINIC LLC (NPI 1629737150) is a healthcare organization registered as a nurse practitioner in Arthur, Illinois and active in the NPI registry since December 2021. The organization lists Jessica Alford, Owner, as its authorized official.

NPPES Registry Identity

NPI1629737150

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameRADICAL ROOTS CLINIC LLC

Location Address2046 JONATHAN CREEK RDArthur, IL 61911-6108

Mailing Address2046 Jonathan Creek RdArthur, IL 61911-6108

Phone(765) 267-1177

Organization SubpartNo

Authorized OfficialJessica AlfordOwner · (765) 267-1177

Enumeration DateDecember 13, 2021

Last NPPES UpdateMay 30, 20222 updates tracked since enumeration

NPPES CertifiedMay 30, 2022

✔ NPI 1629737150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedSocial WorkerTaxonomy 104100000X

2046 JONATHAN CREEK RD, Arthur, IL 61911

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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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