Active NPI
Elissa Suzanne Drake, LDEM, CPM
- Midwife
- Layton, UT
National Provider Identifier
1033891791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 6225016-3400
- Practice address
- 1660 W Antelope Dr
Layton, UT 84041-1156 - Phone
- (801) 917-6104
- NPI assigned
- Aug 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 6225016-3400 | UT | Primary |
Addresses
Primary practice location
1660 W Antelope Dr
Layton, UT 84041-1156
Mailing address
703 N 1050 W
Clearfield, UT 84015-9331
Phone (801) 686-0154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6225016-3400 | UT | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1033891791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 N 1050 W",
"city": "CLEARFIELD",
"state": "UT",
"postal_code": "840159331",
"telephone_number": "801-686-0154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 W ANTELOPE DR",
"city": "LAYTON",
"state": "UT",
"postal_code": "840411156",
"telephone_number": "801-917-6104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "ELISSA",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "LDEM, CPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-02",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "UT",
"license": "6225016-3400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.