Individual provider Active NPI

Malynn Theresa Drake, D.C.

  • Chiropractor
  • Edison, NJ
National Provider Identifier
1235465576
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00738900 Issued in NJ
Practice address
72 Route 27
Edison, NJ 08820-3986
Phone
(732) 662-9901
Fax
(732) 662-9904
NPI assigned
Oct 21, 2009
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-31279 CA
Chiropractor 111N00000X 38MC00738900 NJ Primary

Addresses

Primary practice location

72 Route 27
Edison, NJ 08820-3986

Mailing address

72 Route 27
Edison, NJ 08820-3986
Phone (732) 662-9901

Other identifiers 1

IdentifierTypeStateIssuer
38MC00738900OtherNJLICENSE NUMBER

Other names 1

  • Dr. Mindy Drake Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170323000290 NJ Practitioner - Chiropractic 9133404775 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 Beaver Dam Rd
PT Pleasant, NJ 08742-4402
Phone (732) 892-2900

654 Newman Springs Rd
Suite F
Lincroft, NJ 07738-1744
Phone (732) 747-0390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-31279CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Monmouth Pain and Rehabilitation PC Chiropractor CurrentSince Mar 15, 2018 Accepting new patients
Monmouth Pain and Rehabiliation PC Chiropractor CurrentSince Mar 15, 2018 Accepting new patients
Levante Chiropractic LLC Chiropractor CurrentSince Feb 26, 2026 Accepting new patients
Eastpointe Integrated Healthcare LLC Chiropractor CurrentSince Feb 1, 2022 Accepting new patients
Westfield Health & Rehabilitation, LLC Chiropractor CurrentSince Aug 23, 2021 Accepting new patients
White Chiropractic Health Center Incorporated Chiropractor CurrentSince Mar 10, 2024 Accepting new patients
Atlantic Back and Body Clinic LLC Chiropractor Past Accepting new patients
Recover Pro Medical & Wellness Chiropractor Past Accepting new patients

Locations

2373 Highway 36
Atlantic Hlds, NJ 07716
Phone (732) 872-6595

654 Newman Springs Rd
Ste F
Lincroft, NJ 07738

1100 Beaver Dam Rd
Point Pleasant Boro, NJ 08742
Phone (732) 892-2900

3100 State Route 138
Ste 3
Wall Township, NJ 07719
Phone (732) 280-9500

222 North Ave W
Ste 1
Westfield, NJ 07090
Phone (908) 928-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1235465576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 ROUTE 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203986",
            "telephone_number": "732-662-9901",
            "fax_number": "732-662-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 ROUTE 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203986",
            "telephone_number": "732-662-9901",
            "fax_number": "732-662-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "MALYNN",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31279",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00738900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "38MC00738900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "DRAKE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.