SERENE ROOTS WELLNESS LLC NPI 1396530374

NPI Information

  • NPI: 1396530374
  • Provider Name: SERENE ROOTS WELLNESS LLC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Address: 1536 BRIDGEWATER LN STE 104
    KINGSPORT, TN
    ZIP 37660
  • Phone: (423) 390-0511

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NPI Details

SERENE ROOTS WELLNESS LLC is a health service clinic center in Kingsport, TN. SERENE ROOTS WELLNESS LLC NPI is 1396530374. The provider is registered as an organization entity type.

The provider's business location address is:

1536 BRIDGEWATER LN STE 104
KINGSPORT, TN
ZIP 37660-103
Phone: (423) 390-0511

The provider's authorized official is Cassandra Butts .
The authorized official title is Owner and has the following contact phone number (423) 390-0511.

The enumeration date for this NPI number is 4/11/2025 and was last updated on 4/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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