WILD ROOTS OT LLC
NPI 1932092178
Clinic/Center in Walland, TN

Q: What is Wild Roots Ot LLC's NPI number?

The NPI number for Wild Roots Ot LLC is 1932092178. It was assigned to this organization in the NPPES registry on May 29, 2025.

Q: What is Wild Roots Ot LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Wild Roots Ot LLC was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since May 29, 2025

1057 OLD OLIVER RD, WALLAND, TN 37886(865) 268-9270 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wild Roots Ot Llc NPPES

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

WILD ROOTS OT LLC (NPI 1932092178) is a healthcare organization registered as a clinic/center in Walland, Tennessee and active in the NPI registry since May 2025. The organization lists Nicole Seravello, Owner, as its authorized official.

NPPES Registry Identity

NPI1932092178

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameWILD ROOTS OT LLC

Location Address1057 OLD OLIVER RDWalland, TN 37886-2338

Mailing Address1057 Old Oliver RdWalland, TN 37886-2338 · (239) 222-9911

Phone(865) 268-9270

Organization SubpartNo

Authorized OfficialNicole SeravelloOwner · (239) 222-9911

Enumeration DateMay 29, 2025

NPPES CertifiedMay 28, 2025

✔ NPI 1932092178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

1057 OLD OLIVER RD, Walland, TN 37886

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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 Wild Roots Ot LLC's NPI number?

The NPI number for Wild Roots Ot LLC is 1932092178. It was assigned to this organization in the NPPES registry on May 29, 2025.

Where is Wild Roots Ot LLC located?

Wild Roots Ot LLC is located at 1057 Old Oliver Rd, Walland, TN 37886. The listed phone number is (865) 268-9270.

What is Wild Roots Ot LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Wild Roots Ot LLC was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.