NPIMap

Individual provider Active NPI

Robert L. Drake, D.O.

  • Cardiovascular Disease Physician
  • Mount Vernon, OH
National Provider Identifier
1194726224
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34007021 Issued in OH
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050
Phone
(740) 393-9000
Fax
(740) 392-0167
NPI assigned
Aug 10, 2005
Last updated
Feb 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34-00-7021-D OH
Cardiovascular Disease Physician 207RC0000X 34007021 OH Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050

Mailing address

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9000

Other identifiers 1

IdentifierTypeStateIssuer
2135988MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100504000572 OH Practitioner - Cardiovascular Disease (Cardiology) 4789712209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio University, College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone (740) 393-9019

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007021OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Jul 1, 2018 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital CurrentSince Jul 1, 2018 Accepting new patients
Knox Community Hospital Current Accepting new patients
Ohiohealth Corporation CurrentSince Apr 24, 2014 Accepting new patients
Ohiohealth Corporation Cardiovascular Disease CurrentSince Apr 24, 2014 Accepting new patients
Knox Community Hospital Current Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5350 Frantz Rd
Dublin, OH 43016

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

208 Columbus St
Hicksville, OH 43526
Phone (419) 542-6692

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

680 Park Ave W
Ste 100
Mansfield, OH 44906
Phone (419) 524-8151

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

Organizations & group practices 7

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1194726224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34-00-7021-D",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34007021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2135988",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.