Jon Drake, AUD
Individual provider Active NPI Audiologist-Hearing Aid Fitter · Albuquerque, NM
NPI 1124337803 · NPPES record last updated Jan 23, 2020
Key facts
- NPI
- 1124337803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist-Hearing Aid Fitter 237600000X
- License
- 80582 (TX)
- Practice address
- 7001 Prospect PL NE
Albuquerque, NM 87110-4311 - Phone
- (505) 764-0036
- Fax
- (505) 764-0446
- NPI assigned
- Sep 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80582 | TX | MD | Mental Health Counselor |
| 80349 | TX | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CGN Epent | Current |
Accepting new patients | |
| Jicarilla IHS Pharmacy | Current |
Accepting new patients | |
| McCrae Hearing Ventures, Inc. | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
| Frances Hearing Instruments Inc | Past | Accepting new patients |
Locations
201 Bartlett Dr
#A
El Paso, TX 79912
Phone (915) 779-5866
5959 Gateway Blvd W
Ste 160
El Paso, TX 79925
Phone (915) 779-5866
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 80582 | TX | Yes |
Addresses
Primary practice location
7001 Prospect PL NE
Albuquerque, NM 87110-4311
Mailing address
701 Oakland Hills LN
Kerrville, TX 78028-6429
Phone (830) 385-2034
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE ASSIGNED | Medicaid | NM |
Other providers in Albuquerque, NM
- Autumn Drags Wolf
- Shalon Drags Wolf
- Jennifer A Drake-Feinberg
- Shana Drake-Lavelle
- Cathy L Drake
- Maria Drake
- Sara Drake
- Stephanie Drake
- Gail M Drane
- Jessica Drane
All providers in Albuquerque, NM · Audiologist-Hearing Aid Fitter in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.