Jordyn Audrey Drake, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125077767 Issued in IL

Practice address

559 Vincent St SPC Base
Peterson AFB, CO 80914-1541

Phone

(719) 567-5536

NPI assigned

Jul 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1114599370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST SPC BASE",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-567-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST SPC BASE",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-567-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "JORDYN",
        "middle_name": "AUDREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036171403",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125077767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanine Marie Czech, M.D.
• Peter Dang
• Anna K Davis, LCSW
• Drew Harrison Dinsmore, DPT
• Carrie Downey, WHNP-BC
• John Frank Drozd, PHD
• Jeffrey Holter Dunn, M.D.
• Tina Golden, RN
• Kelsiann Goyne, PHYSICIAN ASSISTANT
• Wayne Erwin Grabow, DENTIST DDS

• Family Medicine Physician in Peterson AFB, CO
• Providers in Peterson AFB, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.