Individual provider Active NPI

Timonia Marizdelle Buchanan, DC

  • Chiropractor
  • Pearland, TX
National Provider Identifier
1396441564
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15226 Issued in TX
Practice address
12155 Shadow Creek Pkwy Ste 115
Pearland, TX 77584-7289
Phone
(832) 243-4353
NPI assigned
Jan 31, 2023
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15226 TX Primary

Addresses

Primary practice location

12155 Shadow Creek Pkwy Ste 115
Pearland, TX 77584-7289

Mailing address

12325 Shadow Creek Pkwy Apt 16209
Pearland, TX 77584-7436
Phone (561) 889-9304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721001149 TN Practitioner - Chiropractic 4082074018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Chiro Place of Collierville PLLCGroup PAC ID 1951600428, 7 clinicians

Practice addresses (Care Compare)

3615 S Houston Levee Rd
Suite 110
Collierville, TN 38017-9173
Phone 90122171735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3727TNMDClinical Psychologist
15226TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Concierge Chiropractic Clinic, LLC Chiropractor CurrentSince Feb 11, 2024 Accepting new patients
The Chiro Place of Collierville PLLC Chiropractor CurrentSince Jun 12, 2023 Accepting new patients
The Chiro Place PLLC Chiropractor PastSince Jun 12, 2023 Accepting new patients
The Chiro Place of Douglasville PC Chiropractor PastSince Sep 24, 2023 Accepting new patients
The Chiro Place of Midtown PLLC Chiropractor PastSince Jan 28, 2019 Accepting new patients

Locations

8101 Hacks Cross Rd
Ste 110
Olive Branch, MS 38654

2690 Kirby Whitten Rd
Ste 109
Bartlett, TN 38133
Phone (901) 217-7173

3615 S Houston Levee Rd
Ste 110
Collierville, TN 38017
Phone (901) 217-7173

3179 Poplar Ave
Memphis, TN 38111
Phone (901) 221-7173

12155 Shadow Creek Pkwy
Ste 115
Pearland, TX 77584
Phone (832) 243-4353

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1396441564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 SHADOW CREEK PKWY APT 16209",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847436",
            "telephone_number": "561-889-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12155 SHADOW CREEK PKWY STE 115",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847289",
            "telephone_number": "832-243-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "TIMONIA",
        "middle_name": "MARIZDELLE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.