Individual provider Active NPI

Nathan Jerome Sermersheim, D.C.

  • Rehabilitation Chiropractor
  • Zionsville, IN
National Provider Identifier
1508100116
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
08002659A Issued in IN
Practice address
1285 Parkway Dr
Zionsville, IN 46077-1953
Phone
(317) 491-1073
Fax
(317) 733-3341
NPI assigned
Nov 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 08002659A IN Primary

Addresses

Primary practice location

1285 Parkway Dr
Zionsville, IN 46077-1953

Mailing address

1285 Parkway Dr
Zionsville, IN 46077-1953
Phone (317) 491-1073

Other practice location 1

2414 E State Blvd
Fort Wayne, IN 46805-4760
Phone (812) 661-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08002659AINMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zionsville Family Chiropractic Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508100116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 PARKWAY DR",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771953",
            "telephone_number": "317-491-1073",
            "fax_number": "317-733-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 PARKWAY DR",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771953",
            "telephone_number": "317-491-1073",
            "fax_number": "317-733-3341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2414 E State Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054760",
            "country_code": "US",
            "telephone_number": "812-661-2751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERMERSHEIM",
        "first_name": "NATHAN",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IN",
            "license": "08002659A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.