NPIMap

Individual provider Active NPI

Kory Drake, DO

  • Nephrology Physician
  • Greenville, SC
National Provider Identifier
1114423522
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
89701 Issued in SC
Practice address
203 Mills Ave
Greenville, SC 29605-4019
Phone
(864) 271-1844
NPI assigned
Apr 4, 2018
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6647 OK
Nephrology Physician 207RN0300X 89701 SC Primary

Addresses

Primary practice location

203 Mills Ave
Greenville, SC 29605-4019

Mailing address

4502 E 41St St
Tulsa, OK 74135-2536
Phone (918) 619-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228001228 SC Practitioner - Nephrology 0547645210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Nephrology PAGroup PAC ID 2961467733, 37 clinicians

Practice addresses (Care Compare)

1410 B John B White Sr Blvd
Spartanburg, SC 29306-3927
Phone (864) 529-9390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6647OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Nephrology PA Nephrology CurrentSince Nov 12, 2023 Accepting new patients
Carolina ASC LLC PastSince May 1, 2024 Accepting new patients

Locations

455 E Whitner St
Anderson, SC 29624
Phone (864) 759-0314

803 N Fant St
Ste 2A
Anderson, SC 29621
Phone (864) 225-7401

400 Plaza Cir
Ste H
Clinton, SC 29325
Phone (864) 833-4166

121 Commerce Blvd
Ste B
Easley, SC 29642
Phone (864) 859-3038

406 Tiffany Park
#B
Gaffney, SC 29341
Phone (864) 663-2736

110 Chalmers Rd
Unit A
Greenville, SC 29605
Phone (864) 977-8200

110 Chalmers Rd
Unit B
Greenville, SC 29605

203 Mills Ave
Greenville, SC 29605
Phone (803) 271-1844

108 W Church St
Greer, SC 29650
Phone (864) 801-9736

45 Aaron Tippin Dr
Greer, SC 29650
Phone (864) 848-5555

110B Hospital Dr
Simpsonville, SC 29681
Phone (864) 382-6940

1410 John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 271-1488

1410B John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 529-9390

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1114423522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-619-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054019",
            "telephone_number": "864-271-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "KORY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "6647",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "89701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.