Individual provider Active NPI

Collin Robert McCulloch, DC

  • Chiropractor
  • Mauston, WI
National Provider Identifier
1629701552
Registry record updated Jun 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6003-12 Issued in WI
Practice address
115 E State St
Mauston, WI 53948-1344
Phone
(608) 524-2616
Fax
(608) 524-3697
NPI assigned
Jul 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6003-12 WI Primary

Addresses

Primary practice location

115 E State St
Mauston, WI 53948-1344

Mailing address

115 E State St
Mauston, WI 53948-1344
Phone (608) 524-2616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722002574 WI Practitioner - Chiropractic 4385025238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Chiropractic Office SCGroup PAC ID 8628171105, 4 clinicians

Practice addresses (Care Compare)

149 N Main St
Adams, WI 53910-9805
Phone (608) 339-4600

420 Viking Dr
Reedsburg, WI 53959-1675
Phone (608) 524-2616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6003-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Align Chiropractic Clinics, LLC Chiropractor CurrentSince Nov 4, 2025 Accepting new patients
Anderson Chiropractic Office,S.C. Chiropractor CurrentSince Sep 2, 2024 Accepting new patients
Anderson Chiropractic Office, SC Chiropractor Current Accepting new patients
Tried and Truce Chiropractic, LLC PastSince Jun 25, 2023 Accepting new patients

Locations

149 N Main St
Adams, WI 53910
Phone (608) 339-4600

115 E State St
Mauston, WI 53948
Phone (608) 524-2616

420 Viking Dr
Reedsburg, WI 53959
Phone (608) 524-2616

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782604800000",
    "number": "1629701552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E STATE ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481344",
            "telephone_number": "608-524-2616",
            "fax_number": "608-524-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E STATE ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481344",
            "telephone_number": "608-524-2616",
            "fax_number": "608-524-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "COLLIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2026-06-28",
        "certification_date": "2026-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6003-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.