Active NPI
Carolyn Drake, S.L.P.
- Speech-Language Pathologist
- Talbott, TN
National Provider Identifier
1073608444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1990
- Practice address
- 6057 West Andrew Johnson Highway
Suite 4
Talbott, TN 37877 - Phone
- (423) 586-9495
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 9, 2007
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1990 | TN | Primary |
Addresses
Primary practice location
6057 West Andrew Johnson Highway
Suite 4
Talbott, TN 37877
Mailing address
6057 West Andrew Johnson Highway
Suite 4
Talbott, TN 37877
Phone (423) 586-9495
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 446679 | Medicaid | TN |
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 |
|---|---|---|---|
| 1990 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1073608444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6057 WEST ANDREW JOHNSON HIGHWAY",
"address_2": "SUITE 4",
"city": "TALBOTT",
"state": "TN",
"postal_code": "37877",
"telephone_number": "423-586-9495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6057 WEST ANDREW JOHNSON HIGHWAY",
"address_2": "SUITE 4",
"city": "TALBOTT",
"state": "TN",
"postal_code": "37877",
"telephone_number": "423-586-9495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "CAROLYN",
"name_prefix": "Mrs.",
"credential": "S.L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "1990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "446679",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Talbott, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.