ALEX G. DRAKE (NPI# 1952720633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952720633 |
| Entity Type | Individual |
| Full Name | ALEX G. DRAKE |
| Credential | MD |
| Practice Address |
630 Medical Dr Bountiful UT 84010-4908 |
| Mailing Address |
333 N 300 W Salt Lake City UT 84103-1215 |
| Practice Telephone | 8012992200 |
| Mailing Telephone | 8014637415 |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2017-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 10345205 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
630 MEDICAL DR |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144201120 | Richard N Hartvigsen | Radiology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2005-11-08 |
| 1932665239 | Stephanie Lynn Blundell | General Acute Care Hospital | 630 Medical Dr, Bountiful, UT 84010-4908 | 2019-02-12 |
| 1205308780 | Janice Trump | Nurse Practitioner | 630 Medical Dr, Bountiful, UT 84010-4908 | 2018-12-21 |
| 1821521337 | Samuel John Kozloff | Internal Medicine | 630 Medical Dr, Bountiful, UT 84010-4908 | 2017-04-11 |
| 1619379971 | Selma Hercinovic | Social Worker | 630 Medical Dr, Bountiful, UT 84010-4908 | 2014-09-18 |
| 1518383546 | Greg Mendiola | Pharmacist | 630 Medical Dr, Bountiful, UT 84010-4908 | 2014-03-14 |
| 1396186409 | Karine Julie Hachon | Nurse Anesthetist, Certified Registered | 630 Medical Dr, Bountiful, UT 84010-4908 | 2013-07-17 |
| 1295071694 | Mountainstar Behavioral Health LLC | Behavioral Analyst | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-12-13 |
| 1174868525 | Mountainstar Behavioral Health LLC | Psychiatry & Neurology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-12-11 |
| 1801168794 | Bountiful Ridge Anesthesia, Pllc | Nurse Anesthetist, Certified Registered | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-02-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003287970 | Marlene Hyndman | Emergency Medicine | 3024 S 600 W, Bountiful, UT 84010-8204 | 2015-10-16 |
| 1134411341 | Michel Maroun Barakat | Emergency Medicine | 3837 Huntington Dr, Bountiful, UT 84010-5842 | 2011-05-05 |
| 1528026978 | Jeffrey Lynn Henderson | Emergency Medicine | 390 N Main St, Bountiful, UT 84010-6046 | 2006-05-03 |
| 1568423564 | Brett Earl | Emergency Medicine | 458 N 500 W, Bountiful, UT 84010-6948 | 2006-03-29 |
| 1689709875 | Ihc Health Services Inc | Emergency Medicine | 390 N Main St, Bountiful, UT 84010-6046 | 2007-02-21 |
| 1427071265 | Bessann Dawson | Emergency Medicine | 280 N Main St, Bountiful, UT 84010-6136 | 2006-07-25 |
| 1114940954 | Catherine E Burton | Emergency Medicine | 280 N Main St, Bountiful, UT 84010-6136 | 2006-07-25 |
| 1982666574 | Jennifer Ross | Emergency Medicine | 520 Medical Dr, Ste #110, Bountiful, UT 84010-4968 | 2006-04-06 |
| 1730158957 | Mark G. Flammer | Emergency Medicine | 520 Medical Dr, Ste 110, Bountiful, UT 84010-4968 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700414216 | True North Health Navigation LLC | Emergency Medicine | 136 E South Temple Ste 1400, Salt Lake City, UT 84111-1143 | 2020-03-30 |
| 1609377589 | David A. Burton | Emergency Medicine | 1040 S Oak Hills Way, Salt Lake City, UT 84108-2024 | 2018-02-26 |
| 1184131922 | Wally Lee | Emergency Medicine | 3539 E Brighton Point Dr, Salt Lake City, UT 84121-5510 | 2018-01-02 |
| 1295240026 | Allison Mcphee | Emergency Medicine | 1021 E 3300 S, Salt Lake City, UT 84106-2142 | 2017-12-01 |
| 1104351592 | David Crockett | Emergency Medicine | University of Utah School of Medicine 30 N 1900 E 1c026, Salt Lake City, UT 84132-2147 | 2017-04-24 |
| 1912384637 | Kyle Earl Nielsen | Emergency Medicine | 2292 N 1430 E, Provo, UT 84604 | 2015-05-01 |
| 1699152538 | Jinghui Li | Emergency Medicine | 2675 W Taylorsville Blvd, Taylorsville, UT 84129-2208 | 2015-04-29 |
| 1699160598 | Sean Damian Slack | Emergency Medicine | Division of Emergency Medicine School Of, 30 N 1900 E 1c026, Salt Lake City, UT 84132-0001 | 2015-03-30 |
| 1801201496 | Dwight Burdick | Emergency Medicine | 2665 E 2100 S, Salt Lake City, UT 84109-1372 | 2014-06-23 |
| 1215340146 | Nathan Kartchner | Emergency Medicine | 38 W Sunset Dr, Cedar City, UT 84720-3545 | 2014-06-09 |
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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.