Trollway Diabetes Inc.

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

TROLLWAY DIABETES INC.

Practice address

640 S 1St St
Mount Horeb, WI 53572-3311

Phone

(608) 684-6686

NPI assigned

Feb 24, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jill Kristen Kietzke, MSN, BC-ADMNPI 1730829508

Title

Program Coordinator

Phone

(608) 512-8115

Specialties & licenses 1

Addresses

Other names 2

• Trollway Diabetes Care Former legal business name
• Trollway Diabetes Care, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Kristen Kietzke, MSN, BC-ADM

  • Health Educator
  • Mount Horeb, WI
  • NPI 1730829508
  NPD Authorized official
• Katelyn Marie Schobert, RD

  • Registered Dietitian
  • Madison, WI
  • NPI 1124637152

  Health Educator

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1124774427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S 1ST ST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535723311",
            "telephone_number": "608-512-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S 1ST ST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535723311",
            "telephone_number": "608-684-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROLLWAY DIABETES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "KIETZKE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "KRISTEN",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "608-512-8115",
        "authorized_official_credential": "MSN, BC-ADM"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trollway Diabetes Care",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Trollway Diabetes Care, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Paul Svingen, CRNA
• Lauren Ta, OD
• Lisa Theis, OT
• Miranda Thill
• Transitions at Home, Inc.
• Brenda Lynn Trudell, D.C.
• University of Wisconsin Medical Foundation Inc
• Upland Hills Health, Inc
• Uro GYN Consultations LLC
• Kori L Vander Yacht, NP

• Health Educator in Mount Horeb, WI
• Providers in Mount Horeb, WI by specialty
• Health Educator in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.