Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mixed Roots LLC

Organization Prosthetic/Orthotic Supplier · NPI 1962263871

Mixed Roots LLC is a Prosthetic/Orthotic Supplier in Raleigh, North Carolina. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6300 Creedmoor Rd Ste 118
Raleigh, NC 27612-6730
Phone: (919) 720-4080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X

Record details

NPI number1962263871
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patricia McCray — Salon Owner · (856) 236-6555
NPI enumeratedJanuary 18, 2024
Last updated in NPPESJanuary 18, 2024
Certification dateJanuary 17, 2024
Mailing address10624 Sunny Point Dr, Zebulon, NC 27597-6880

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