ROOTED WINGS LLC
NPI 1629868252
Counselor - Professional in Pacolet, SC
About Rooted Wings Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROOTED WINGS LLC (NPI 1629868252) is a healthcare organization registered as a professional in Pacolet, South Carolina and active in the NPI registry since May 2025. The organization lists Stacey L Jackson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rooted Wings Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Rooted Wings LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Rooted Wings LLC's NPI number?
The NPI number for Rooted Wings LLC is 1629868252. It was assigned to this organization in the NPPES registry on May 7, 2025.
Where is Rooted Wings LLC located?
Rooted Wings LLC is located at 131 Cameron St, Pacolet, SC 29372. The listed phone number is (864) 398-9322.
What is Rooted Wings LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Rooted Wings LLC enrolled in Medicare?
Yes. Rooted Wings LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rooted Wings LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Rooted Wings LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Rooted Wings LLC was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Rooted Wings Llc · NPI 1629868252
Professional organization in Pacolet, South Carolina. Organization record, active in the CMS NPPES registry since May 7, 2025.
## Identity
- **NPI:** 1629868252 (Entity type: Organization)
- **Enumerated:** May 7, 2025
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Organization subpart:** No
- **Authorized official:** Stacey Jackson, OWNER
## Practice location
- **Address:** 131 CAMERON ST, Pacolet, SC 29372-2838
- **Phone:** (864) 398-9322 · **Fax:** (888) 707-1002
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1629868252) · Data from the CMS NPPES public registry.