Kaitlin Landowski, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1106 Issued in ND

Practice address

3240 15TH St S Ste C
Fargo, ND 58104-6188

Phone

(701) 451-9070

Fax

(701) 364-5318

NPI assigned

Jun 14, 2019

Last updated

Jun 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illuminnate Chiropractic PLLCGroup PAC ID 5799155255, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Illuminnate Chiropractic PLLC

  • Health Service Clinic/Center
  • Fargo, ND
  • NPI 1205551694
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1952961716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 15TH ST S STE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046188",
            "telephone_number": "701-451-9070",
            "fax_number": "701-364-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 15TH ST S STE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046188",
            "telephone_number": "701-451-9070",
            "fax_number": "701-364-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDOWSKI",
        "first_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lance K Bergstrom MD, PC (Bergstrom Eye and Laser Clinic)
• Daniel Barrett Landauer, PHD
• Nicole Landen, CRNA
• Joshua Landis, LBSW
• Katelynn Landis
• Jennifer Landphere, B.S., LAC
• Monica Landry, DC
• Zachary Landry
• Hannah Laney
• Alexandra Lang, PHARMD

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.