Individual provider Active NPI

John S Nelson, DC

  • Chiropractor
  • Spearfish, SD
National Provider Identifier
1356355853
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
SD-555 Issued in SD
Practice address
1930 North Ave
Spearfish, SD 57783-0127
Phone
(605) 642-5196
Fax
(605) 642-4409
NPI assigned
Jul 28, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X SD-555 SD Primary

Addresses

Primary practice location

1930 North Ave
Spearfish, SD 57783-0127

Mailing address

PO Box 127
Spearfish, SD 57783-0127
Phone (605) 642-5196

Other identifiers 2

IdentifierTypeStateIssuer
S3089OtherSDGROUP
7600270MedicaidSD

Other names 1

  • J S Nelson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000161 SD Practitioner - Chiropractic 4183808280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J S Nelson P CGroup PAC ID 4789665290, 3 clinicians

Practice addresses (Care Compare)

1930 N Ave
Spearfish, SD 57783-2913
Phone (605) 642-5196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SD-555SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
J S Nelson P C Chiropractor CurrentSince Jan 1, 1973 Accepting new patients

Locations

1930 North Ave
Spearfish, SD 57783
Phone (605) 639-5641

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1356355853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577830127",
            "telephone_number": "605-642-5196",
            "fax_number": "605-642-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 NORTH AVE",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577830127",
            "telephone_number": "605-642-5196",
            "fax_number": "605-642-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "SD-555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "S3089",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600270",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "NELSON",
            "middle_name": "S",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.