Individual provider Active NPI

Timika Lashaun Frazier, D.C.

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1972851152
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1344 Issued in MS
Practice address
1712 Penny LN SE
Marietta, GA 30067-4434
Phone
(601) 291-2597
NPI assigned
Aug 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 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 1344 MS Primary

Addresses

Primary practice location

1712 Penny LN SE
Marietta, GA 30067-4434

Mailing address

4377 Redwood Cir
Jackson, MS 39212-3636
Phone (601) 291-2597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230322000882 MS Practitioner - Chiropractic 0244604825 Reassigns benefits to 1 organization
I20240606002213 AL Practitioner - Chiropractic 0244604825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Chiropractic, LLCGroup PAC ID 9335219419, 3 clinicians

Practice addresses (Care Compare)

11322 US Hwy 31
Daphne, AL 36527-5897
Phone (251) 626-8242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Chiropractic, LLC Chiropractor CurrentSince May 24, 2024 Accepting new patients
Align Chiropractic PC CurrentSince Mar 6, 2023 Accepting new patients
Stonestar Health LLC CurrentSince Nov 17, 2025 Accepting new patients

Locations

131 Market Pl
Montgomery, AL 36117
Phone (334) 239-7641

11322 US Highway 31
Spanish Fort, AL 36527
Phone (251) 626-8242

202 Walnut Dr
Ocean Springs, MS 39564
Phone (228) 447-3200

Organizations & group practices 3

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1972851152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4377 REDWOOD CIR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392123636",
            "telephone_number": "601-291-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 PENNY LN SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674434",
            "telephone_number": "601-291-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "TIMIKA",
        "middle_name": "LASHAUN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.