DOUGLAS A. DRAKE (NPI# 1770817348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770817348 |
Entity Type | Individual |
Full Name | DOUGLAS A. DRAKE |
Credential | PA-C |
Practice Address |
370 E Virginia Ave Phoenix AZ 85004-1214 |
Mailing Address |
Po Box 843456 Los Angeles CA 90084-3456 |
Practice Telephone | 6022584788 |
Practice Fax Number | 6022585131 |
Mailing Telephone | 6022584788 |
Mailing Fax Number | 6022585131 |
Enumeration Date | 2009-09-29 |
Last Update Date | 2014-02-05 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | PA60162605 | WA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60162605 | WA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5432 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60162605 | WA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCCPA | 1086241 | 01 | |
AZ | 835649 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093051484 | Douglas Drake | Hearing Instrument Specialist | 5910 E State St, Rockford, IL 61108-2430 | 2012-12-13 |
1356499255 | Douglas A Drake | Physician Assistant | 4647 Zion Ave, San Diego, CA 92120-2507 | 2007-01-08 |
1063425494 | Douglas Albert Drake | Orthopaedic Surgery | 4010 W 65th St, Edina, MN 55435-1706 | 2006-08-15 |
Street Address |
370 E VIRGINIA AVE |
City | PHOENIX |
State | AZ |
Zip Code | 85004-1214 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972502227 | Arizona Center for Hand Surgery PC | Orthopaedic Surgery | 370 E Virginia Ave, Suite 100, Phoenix, AZ 85004-1214 | 2005-07-19 |
1265897227 | Allison Voelker | Physician Assistant | 370 E Virginia Ave, Suite 100, Phoenix, AZ 85004-1214 | 2015-12-17 |
1609243880 | Yakima Brown | Physician Assistant | 370 E Virginia Ave, Suite 100, Phoenix, AZ 85004-1214 | 2015-08-24 |
1578965067 | Regan R Alford | Physician Assistant | 370 E Virginia Ave, Ste 100, Phoenix, AZ 85004-1214 | 2014-09-16 |
1588065502 | Duane J Fenn | Physician Assistant | 370 E Virginia Ave, 100, Phoenix, AZ 85004-1214 | 2014-09-09 |
1114347465 | Rehab Management LLC | Occupational Therapy Assistant | 370 E Virginia Ave, Phoenix, AZ 85004-1214 | 2014-04-24 |
1982959698 | Arizona Center for Hand Surgery PC | Durable Medical Equipment & Medical Supplies | 370 E Virginia Ave, 100, Phoenix, AZ 85004-1214 | 2012-07-18 |
1518107879 | Edward M Reece Md Pllc | Surgery | 370 E Virginia Ave, Ste 100, Phoenix, AZ 85004-1214 | 2009-02-26 |
1073761169 | Dr Steven D Bastian Pllc | Surgery | 370 E Virginia Ave, Suite 100, Phoenix, AZ 85004-1214 | 2008-09-03 |
1225228406 | Elizabeth Rose Colburn | Specialist/Technologist | 370 E Virginia Ave, #200, Phoenix, AZ 85004-1214 | 2007-07-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
Find all providers in zip 85004 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831630375 | Surgeassist, Pllc | Physician Assistant | 125 N 2nd St Ste 110, #443, Phoenix, AZ 85004-2427 | 2017-03-16 |
1245695139 | Alex Hall | Physician Assistant | 15830 N 35th Ave Ste 1, Phoenix, AZ 85053-7640 | 2015-12-21 |
1730550146 | Jennifer Zazueta | Physician Assistant | 4126 E Nighthawk Way, Phoenix, AZ 85048 | 2015-10-12 |
1598047367 | James P. Ennis II | Physician Assistant | 4023 Cloverland Drive, Phoenix, MD 21131-2139 | 2011-09-16 |
1023327251 | Perry A. Brazel | Physician Assistant | 3815 E Bell Rd Ste 2100, Phoenix, AZ 85032-2134 | 2010-10-06 |
1720305535 | Arizona Surgeons Assistant PC | Physician Assistant | 4369 E Hartford Ave, Phoenix, AZ 85032-2298 | 2010-05-03 |
1023296381 | On-call Surgical Assistants LLC | Physician Assistant | 5710 W Spur Dr, Phoenix, AZ 85083-1245 | 2008-02-08 |
1760527725 | North Valley Surgical Assisting, Inc. | Physician Assistant | 4150 W. Peoria Ave, Ste 121, Phoenix, AZ 85029 | 2007-02-20 |
1548321136 | Laura M Hanschka | Physician Assistant | 5025 N Central Ave # 148, Phoenix, AZ 85012-1520 | 2006-12-13 |
1134148513 | Corey L Thompson | Physician Assistant | 4340 E Indian School Rd, Ste 21-562, Phoenix, AZ 85018-5360 | 2006-07-18 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.