Michael A Drake, PSY D HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040859A Issued in IN

Practice address

121 Buntin St Ste 1
Vincennes, IN 47591-1320

Phone

(812) 885-2718

Fax

(812) 885-2727

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Good Samaritan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Vincennes, IN
  • NPI 1174031256

  IN

  Medicare reassignment NPD
• Good Samaritan Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, IN
  • NPI 1063302545
  NPD
• Good Samaritan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, IN
  • NPI 1033827621
  NPD (past)
• Good Samaritan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Loogootee, IN
  • NPI 1124736715
  NPD (past)
• Good Samaritan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Vincennes, IN
  • NPI 1518676907
  NPD (past)
• Good Samaritan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Vincennes, IN
  • NPI 1629787767
  NPD (past)
• Good Samaritan Family Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vincennes, IN
  • NPI 1679282164
  NPD (past)
• Good Samaritan Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Petersburg, IN
  • NPI 1780392373
  NPD (past)
• Good Samaritan Hospital Physician Services Inc.

  • Radiation Oncology Physician
  • Vincennes, IN
  • NPI 1629050646
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1023095338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BAYOU ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911034",
            "telephone_number": "812-886-6800",
            "fax_number": "812-886-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BUNTIN ST STE 1",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911320",
            "telephone_number": "812-885-2718",
            "fax_number": "812-885-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY D HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040859A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000188318",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200082820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Dove
• Jami L Dowell, FNP
• Brian J Doyle, D.D.S
• Kara J Doyle
• Dr Cheryl McCormick Optometrist, PC
• Michael Dreiman
• Leonid Drozhinin
• Duesterberg Drug Co Inc
• Michael Dulin, MD
• Kloee Dunbar

• All providers in Vincennes, IN
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.