Samantha Jo Neilsen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038014283 Issued in IL

Practice address

1877 Daimler Rd
Rockford, IL 61112-1005

Phone

(815) 398-3434

Fax

(815) 398-3548

NPI assigned

Mar 14, 2025

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 IL, WI2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hulsebus Rockford ChiropracticGroup PAC ID 4486796232, 3 clinicians

Revive Chiropractic Care, LLC.Group PAC ID 7517348352, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Hulsebus Rockford Chiropractic

  • Chiropractor
  • Rockford, IL
  • NPI 1104931427
  Medicare reassignment Care Compare group NPD
• Revive Chiropractic Care, LLC.

  • Chiropractor
  • Fitchburg, WI
  • NPI 1073243457
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1083414528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 DAIMLER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121005",
            "telephone_number": "815-398-3434",
            "fax_number": "815-398-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 DAIMLER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121005",
            "telephone_number": "815-398-3434",
            "fax_number": "815-398-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038014283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terra Ann Naumowich, PHARMD
• Karla M Navarro-Vega, PA-C
• Neck to Back Rockford LLC
• Amanda Jane Nedved
• Nicole Negus, NP
• Abigail L Nelson VII
• Andrea Nelson, LPC, RN
• Gabrielle Nelson
• Jonathan Ray Nelson, LPTA
• Jonathan Scott Nelson, LCPC

• Chiropractor in Rockford, IL
• Providers in Rockford, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.