Individual provider Active NPI

Bradley Ian Fraser, D.C.

  • Chiropractor
  • Hixson, TN
National Provider Identifier
1306179130
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008548 Issued in GA
Practice address
5617 Highway 153
Suite 201
Hixson, TN 37343-4675
Phone
(423) 648-0257
Fax
(423) 648-0263
NPI assigned
Sep 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2476 TN
Chiropractor 111N00000X CHIR008548 GA Primary

Addresses

Primary practice location

5617 Highway 153
Suite 201
Hixson, TN 37343-4675

Mailing address

5617 Highway 153
Suite 201
Hixson, TN 37343-4675
Phone (423) 648-0257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008548GAMDChiropractor
2476TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hixon Family Chiropractic PLC Chiropractor Past Accepting new patients

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1306179130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617 HIGHWAY 153",
            "address_2": "SUITE 201",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434675",
            "telephone_number": "423-648-0257",
            "fax_number": "423-648-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5617 HIGHWAY 153",
            "address_2": "SUITE 201",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434675",
            "telephone_number": "423-648-0257",
            "fax_number": "423-648-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "BRADLEY",
        "middle_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-11",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2476",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.