Active NPI
Shannon Glynn Drake, NP-C
- Family Nurse Practitioner
- Houston, TX
National Provider Identifier
1134649619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP133523
- Practice address
- 2425 West Loop S Ste 200
Houston, TX 77027-4208 - Phone
- (832) 786-4970
- Fax
- (855) 722-0157
- NPI assigned
- Jun 26, 2017
- Last updated
- Sep 24, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP133523 | TX | Primary |
Addresses
Primary practice location
2425 West Loop S Ste 200
Houston, TX 77027-4208
Mailing address
333 Commerce St Ste 700
Nashville, TN 37201-1835
Phone (615) 454-9850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170726002161 | TX | Practitioner - Nurse Practitioner | 7416227228 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP133523 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1134649619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 COMMERCE ST STE 700",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372011835",
"telephone_number": "615-454-9850",
"fax_number": "888-494-2588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 WEST LOOP S STE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770274208",
"telephone_number": "832-786-4970",
"fax_number": "855-722-0157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "SHANNON",
"middle_name": "GLYNN",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-26",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP133523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.