Individual provider Active NPI

Jared Erdmier, DC

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1477849099
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011826 Issued in IL
Practice address
863 S Perryville Rd Unit 100
Rockford, IL 61108-4328
Phone
(779) 423-2044
Fax
(779) 423-2045
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011826 IL Primary

Addresses

Primary practice location

863 S Perryville Rd Unit 100
Rockford, IL 61108-4328

Mailing address

863 S Perryville Rd
Ste 100
Rockford, IL 61108-4328
Phone (779) 242-3204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110914000419 IL Practitioner - Chiropractic 7315118874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic First of RockfordGroup PAC ID 4880865336, 9 clinicians

Practice addresses (Care Compare)

863 S Perryville Rd
Unit 100
Rockford, IL 61108-4328
Phone (779) 423-2044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011826ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Medical of Rockford Current Accepting new patients
Chiropractic First of Rockford Chiropractor CurrentSince Aug 22, 2011 Accepting new patients

Locations

863 S Perryville Rd
Unit 100
Rockford, IL 61108
Phone (779) 423-2044

863 S Perryville Rd
Ste 100
Rockford, IL 61108
Phone (779) 423-2044

811 S Perryville Rd
Unit 117
Rockford, IL 61108
Phone (779) 423-2044

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1477849099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 S PERRYVILLE RD",
            "address_2": "STE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084328",
            "telephone_number": "779-242-3204",
            "fax_number": "779-423-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 S PERRYVILLE RD UNIT 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084328",
            "telephone_number": "779-423-2044",
            "fax_number": "779-423-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMIER",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

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