Individual provider Active NPI

Ryan Turner Nelson, D.C.

  • Chiropractor
  • Clewiston, FL
National Provider Identifier
1902124688
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9995 Issued in FL
Practice address
905 W Ventura Ave
Clewiston, FL 33440-3411
Phone
(863) 983-8391
NPI assigned
May 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9995 FL Primary

Addresses

Primary practice location

905 W Ventura Ave
Clewiston, FL 33440-3411

Mailing address

PO Box 196
Pahokee, FL 33476-0196
Phone (561) 924-2243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110124000977 FL Practitioner - Chiropractic 7719166768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nelson Chiropractic and Rehabilitation LLCGroup PAC ID 2163601014, 2 clinicians

Practice addresses (Care Compare)

905 W Ventura Ave
Clewiston, FL 33440-3411
Phone (863) 983-8391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9995FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nelson Chiropractic & Rehabilitation LLC CurrentSince Sep 18, 2010 Accepting new patients
Vickers Chiropractic Health Centers PA Chiropractor Past Accepting new patients

Locations

905 W Ventura Ave
Clewiston, FL 33440
Phone (863) 983-8391

346 Bacom Point Rd
Pahokee, FL 33476
Phone (561) 924-2243

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": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1902124688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196",
            "city": "PAHOKEE",
            "state": "FL",
            "postal_code": "334760196",
            "telephone_number": "561-924-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W VENTURA AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403411",
            "telephone_number": "863-983-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RYAN",
        "middle_name": "TURNER",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clewiston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.