DYNAMIC ROOTS WELLNESS
NPI 1942789052
Clinic/Center - Health Service in Hamilton, MT
About Dynamic Roots Wellness NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DYNAMIC ROOTS WELLNESS (NPI 1942789052) is a healthcare organization registered as a health service in Hamilton, Montana and active in the NPI registry since August 2018. The organization holds a CLIA Waiver certificate valid through January 17, 2028 and lists Angela Rea Haugo, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dynamic Roots Wellness 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 Dynamic Roots Wellness, 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.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 27D2142712
Dynamic Roots Wellness · Hamilton, MTFrequently 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 Dynamic Roots Wellness's NPI number?
The NPI number for Dynamic Roots Wellness is 1942789052. It was assigned to this organization in the NPPES registry on August 9, 2018.
Where is Dynamic Roots Wellness located?
Dynamic Roots Wellness is located at 605 S 1st St, Hamilton, MT 59840. The listed phone number is (406) 360-2101.
What is Dynamic Roots Wellness's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Dynamic Roots Wellness enrolled in Medicare?
Yes. Dynamic Roots Wellness is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Dynamic Roots Wellness?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Dynamic Roots Wellness. 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.
Does Dynamic Roots Wellness hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 27D2142712) is associated with this NPI, valid through January 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Dynamic Roots Wellness was last updated on August 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Dynamic Roots Wellness · NPI 1942789052
Health Service organization in Hamilton, Montana. Organization record, active in the CMS NPPES registry since August 9, 2018.
## Identity
- **NPI:** 1942789052 (Entity type: Organization)
- **Enumerated:** August 9, 2018
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Angela Haugo, PHYSICIAN
## Practice location
- **Address:** 605 S 1ST ST, Hamilton, MT 59840-2812
- **Phone:** (406) 360-2101 · **Fax:** (406) 363-7092
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 9, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1942789052) · Data from the CMS NPPES public registry.