Individual provider Active NPI

Chad J Nielson, D.C.

  • Chiropractor
  • Twin Falls, ID
National Provider Identifier
1952458127
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1068 Issued in ID
Practice address
260 Falls Ave
Suite B
Twin Falls, ID 83301-3370
Phone
(208) 733-2322
Fax
(208) 733-2224
NPI assigned
Jan 3, 2007
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 CHIA-1068 ID Primary

Addresses

Primary practice location

260 Falls Ave
Suite B
Twin Falls, ID 83301-3370

Mailing address

260 Falls Ave
Suite B
Twin Falls, ID 83301-3370
Phone (208) 733-2322

Other identifiers 2

IdentifierTypeStateIssuer
C4140OtherIDBLUE CROSS
000010147143OtherIDBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000777 ID Practitioner - Chiropractic 2264408541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1330 Filer Ave E
Twin Falls, ID 83301-4119
Phone (208) 733-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1068IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nielson Family Chiropractic Inc Chiropractor CurrentSince Aug 1, 2004 Accepting new patients

Locations

1330 Filer Ave E
Twin Falls, ID 83301
Phone (208) 732-1205

260 Falls Ave
Ste B
Twin Falls, ID 83301
Phone (208) 539-3155

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952458127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 FALLS AVE",
            "address_2": "SUITE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013370",
            "telephone_number": "208-733-2322",
            "fax_number": "208-733-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 FALLS AVE",
            "address_2": "SUITE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013370",
            "telephone_number": "208-733-2322",
            "fax_number": "208-733-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "CHAD",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C4140",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010147143",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

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.