NPIMap

Organization Active NPI

Trillium Spinal Care PLC

  • Chiropractor
  • Rochester, MN
National Provider Identifier
1851839955
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6314 Issued in MN
Legal business name
TRILLIUM SPINAL CARE PLC
Practice address
2300 Superior Dr NW
Suite 2
Rochester, MN 55901-3061
Phone
(507) 322-0133
NPI assigned
Feb 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Authorized official

Name
Dr. Kalan Clete Stittleburg, D.C.NPI 1912445917
Title
Owner
Phone
(715) 937-0549

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 6314 MN Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 6317 MN

Addresses

Primary practice location

2300 Superior Dr NW
Suite 2
Rochester, MN 55901-3061

Mailing address

2300 Superior Dr NW
Suite 2
Rochester, MN 55901-3061
Phone (507) 322-0133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170501002312 MN Part B Supplier - Clinic/Group Practice 5799062659 Receives reassigned benefits from 1 practitioner
Practice locations: Eyota, MN
O20250206000078 WI Part B Supplier - Clinic/Group Practice 5799062659 Receives reassigned benefits from 1 practitioner
Practice locations: Altoona, WI

National Provider Directory

National Provider Directory

Locations

2300 Superior Dr NW
Ste 2
Rochester, MN 55901
Phone (507) 322-0133

913 S Hillcrest Pkwy
Altoona, WI 54720
Phone (715) 895-8048

Practitioners & affiliated clinicians

Practitioners 3

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": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1851839955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SUPERIOR DR NW",
            "address_2": "SUITE 2",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013061",
            "telephone_number": "507-322-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SUPERIOR DR NW",
            "address_2": "SUITE 2",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013061",
            "telephone_number": "507-322-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM SPINAL CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "STITTLEBURG",
        "authorized_official_first_name": "KALAN",
        "authorized_official_middle_name": "CLETE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-937-0549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6314",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.