NPIMap

Individual provider Active NPI

Derek Julius Nelson, D.C.

  • Chiropractor
  • Rapid City, SD
National Provider Identifier
1902070659
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1130 Issued in SD
Practice address
2001 Hope CT Ste 3
Rapid City, SD 57701-1055
Phone
(605) 791-5522
Fax
(605) 791-0929
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1130 SD Primary

Addresses

Primary practice location

2001 Hope CT Ste 3
Rapid City, SD 57701-1055

Mailing address

2001 Hope CT Ste 3
Rapid City, SD 57701-1055
Phone (605) 791-5522

Other identifiers 1

IdentifierTypeStateIssuer
7604950MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080507000160 SD Practitioner - Chiropractic 6305925025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 Hope CT
Suite 3
Rapid City, SD 57701-1055
Phone (605) 791-5522

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nelson Chiropractic, PC Chiropractor CurrentSince Nov 22, 2016 Accepting new patients

Locations

2001 Hope Ct
Ste 3
Rapid City, SD 57701
Phone (605) 791-5522

5734 Sheridan Lake Rd
Ste 201
Rapid City, SD 57702
Phone (605) 791-5522

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1902070659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 HOPE CT STE 3",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011055",
            "telephone_number": "605-791-5522",
            "fax_number": "605-791-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 HOPE CT STE 3",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011055",
            "telephone_number": "605-791-5522",
            "fax_number": "605-791-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DEREK",
        "middle_name": "JULIUS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7604950",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.