Individual provider Active NPI

Tyler Scott Nelson, D.C.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1740394865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2115 Issued in NC
Practice address
5434 Yadkin Rd
Fayetteville, NC 28303-3199
Phone
(910) 860-9119
Fax
(910) 860-8736
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 2115 NC Primary

Addresses

Primary practice location

5434 Yadkin Rd
Fayetteville, NC 28303-3199

Mailing address

6919 Surrey Rd
Fayetteville, NC 28306-2555
Phone (910) 964-2071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129002419 NC Practitioner - Chiropractic 3971883414 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5434 Yadkin Rd
Fayetteville, NC 28303-3199
Phone (910) 860-9119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2115NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nelson & Nelson Chiropractic, P.C. Chiropractor CurrentSince Oct 12, 2016 Accepting new patients
Nelson & Nelson VI, P.C. Chiropractor CurrentSince Oct 12, 2016 Accepting new patients
Nelson Brothers Chiropractic, P.C. Chiropractor CurrentSince Sep 29, 2016 Accepting new patients
Nelson & Nelson III, P.C. Chiropractor CurrentSince Oct 12, 2016 Accepting new patients
Nelson & Nelson IV, P.C. Chiropractor CurrentSince Oct 12, 2016 Accepting new patients

Locations

6021 Raeford Rd
Ste 101
Fayetteville, NC 28304
Phone (910) 860-5559

2807 Ramsey St
Fayetteville, NC 28301
Phone (910) 488-4009

5434 Yadkin Rd
Fayetteville, NC 28303
Phone (910) 860-9119

3202 N Main St
Ste 100
Hope Mills, NC 28348
Phone (910) 401-6813

409 E 2nd St
Lumberton, NC 28358
Phone (910) 608-2224

Organizations & group practices 5

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740394865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 SURREY RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062555",
            "telephone_number": "910-964-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5434 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033199",
            "telephone_number": "910-860-9119",
            "fax_number": "910-860-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.