Organization Active NPI

TLC Chiropractic, PLC

  • Chiropractor
  • Virginia, MN
National Provider Identifier
1295122760
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5857 Issued in MN
Legal business name
TLC CHIROPRACTIC, PLC
Practice address
310 S 2ND Ave
Virginia, MN 55792-2616
Phone
(218) 741-3402
NPI assigned
Apr 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Dr. Tawnee Croteau, D.C.NPI 1639595598
Title
Chiropractor
Phone
(218) 750-0760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5857 MN Primary

Addresses

Primary practice location

310 S 2ND Ave
Virginia, MN 55792-2616

Mailing address

310 S 2ND Ave
Virginia, MN 55792-2616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150609001328 MN Part B Supplier - Clinic/Group Practice 5799006243 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia, MN

National Provider Directory

National Provider Directory

Locations

8355 Unity Dr
Ste 300
Virginia, MN 55792
Phone (218) 248-8472

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1295122760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S 2ND AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S 2ND AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922616",
            "telephone_number": "218-741-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC CHIROPRACTIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "CROTEAU",
        "authorized_official_first_name": "TAWNEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "218-750-0760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.