Organization Active NPI

Nelson Chiropractic S C

Doing business as Nelson Chiropractic

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1467631309
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
042.617841 Issued in IL
Legal business name
NELSON CHIROPRACTIC S C
Doing business as
Nelson Chiropractic
Practice address
7800 N Sommer St Ste 203
Peoria, IL 61615-1990
Phone
(309) 691-9767
Fax
(309) 691-9457
NPI assigned
Oct 28, 2007
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Rodney Loren NelsonNPI 1982793881
Title
President
Phone
(309) 691-9767

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 042.617841 IL Primary

Addresses

Primary practice location

7800 N Sommer St Ste 203
Peoria, IL 61615-1990

Mailing address

7800 N Sommer St Ste 203
Peoria, IL 61615-1990
Phone (309) 691-9767

Other identifiers 1

IdentifierTypeStateIssuer
212653OtherILMEDICARE GROUP ID

Other names 1

  • Nelson Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051202000734 IL Part B Supplier - Clinic/Group Practice 1759301880 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1467631309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST STE 203",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151990",
            "telephone_number": "309-691-9767",
            "fax_number": "309-691-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST STE 203",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151990",
            "telephone_number": "309-691-9767",
            "fax_number": "309-691-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON CHIROPRACTIC S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-28",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "LOREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-9767"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "042.617841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "212653",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nelson Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.