1. Home
  2. Directory
  3. Illinois
  4. Rockford
  5. Chiropractor
  6. NPI Profile

SAMANTHA JO NEILSEN DC
NPI 1083414528
Chiropractor in Rockford, IL

Active since March 14, 2025Accepts Medicare Assignment
1877 DAIMLER RD, ROCKFORD, IL 61112(815) 398-3434(815) 398-3548 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Samantha Jo Neilsen Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA JO NEILSEN DC (NPI 1083414528) is an individual chiropractor in Rockford, Illinois, licensed in Illinois (038014283) and active in the NPI registry since March 2025. She is a graduate of Palmer College Chiropractic - Davenport (2025).

NPPES Registry Identity

NPI1083414528
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameSAMANTHA JO NEILSENCredential: DC
Location Address1877 DAIMLER RDRockford, IL 61112-1005
Mailing Address1877 Daimler RdRockford, IL 61112-1005 · (815) 398-3434 · Fax (815) 398-3548
Phone(815) 398-3434
Fax(815) 398-3548
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 2025
Enumeration DateMarch 14, 2025
NPPES CertifiedMarch 14, 2025
✔ NPI 1083414528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038014283
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1877 DAIMLER RD, Rockford, IL 61112
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Jo Neilsen Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820515604
PECOS Enrollment IDI20250506000561, I20251211002888

Medicare Billing Reassignments

2

Medicare enrollment records show Samantha Neilsen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hulsebus Rockford Chiropractic, LLC
0.1 mi
Chiropractor
1877 DAIMLER RD
Rockford, IL 61112
  • Reassigned Medicare billing, Illinois enrollment
  • 4 clinicians in this Medicare group
NPI 1104931427 (815) 398-3434
Revive Chiropractic Care, LLC.
58 mi
Chiropractor
3151 FISH HATCHERY RD
Fitchburg, WI 53713
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2 clinicians in this Medicare group
NPI 1073243457 (620) 794-7234

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HULSEBUS ROCKFORD CHIROPRACTIC, LLC
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
DR. MARTIN D BRANTNER D.C.
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
DR. MICHAEL JOHN HULSEBUS D.C.
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
DR. BRANT DAVID HULSEBUS D.C.
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
THOMAS DACE
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
DR. DANIEL GORDON THORSTENSON DC
Chiropractor
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
LILIA MENDOZA
Massage Therapist
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434
JESSICA METZ LMT
Massage Therapist
1877 DAIMLER RD
ROCKFORD, IL 61112
Winnebago County (815) 398-3434

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Neilsen's NPI number?

The NPI number for Samantha Neilsen is 1083414528. It was assigned to this individual provider in the NPPES registry on March 14, 2025.

Where is Samantha Neilsen located?

Samantha Neilsen practices at 1877 Daimler Rd, Rockford, IL 61112. The listed phone number is (815) 398-3434.

What is Samantha Neilsen's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Samantha Neilsen enrolled in Medicare?

Yes. Samantha Neilsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samantha Neilsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Neilsen reassigns Medicare benefits to 2 organizations: Hulsebus Rockford Chiropractic, LLC (Rockford, IL) and Revive Chiropractic Care, LLC. (Fitchburg, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Neilsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Neilsen was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.