Active NPI
Cheryl Drake, L.AC.
- Acupuncturist
- South Lake Tahoe, CA
National Provider Identifier
1245689181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC3013
- Practice address
- 2580 Lake Tahoe Blvd Ste a
South Lake Tahoe, CA 96150-7723 - Phone
- (530) 643-0113
- NPI assigned
- Jun 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC3013 | CA | Primary |
Addresses
Primary practice location
2580 Lake Tahoe Blvd Ste a
South Lake Tahoe, CA 96150-7723
Mailing address
PO Box 13125
South Lake Tahoe, CA 96151-3125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC3013 | Other | CA | ACUPUNCTURE BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC3013 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1245689181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13125",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961513125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2580 LAKE TAHOE BLVD STE A",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507723",
"telephone_number": "530-643-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "CHERYL",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC3013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACUPUNCTURE BOARD",
"identifier": "AC3013",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.