Individual provider Active NPI

William Baker Drake III, M.D.

  • Pediatric Cardiology Physician
  • Kansas City, MO
National Provider Identifier
1255389920
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
119862 Issued in MO
Practice address
4150 N Mulberry Dr
Suite 150
Kansas City, MO 64116-1779
Phone
(816) 584-0505
Fax
(816) 265-6333
NPI assigned
May 5, 2006
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 119862 MO Primary

Addresses

Primary practice location

4150 N Mulberry Dr
Suite 150
Kansas City, MO 64116-1779

Mailing address

4150 N Mulberry Dr
Suite 150
Kansas City, MO 64116-1779
Phone (816) 584-0505

Other identifiers 1

IdentifierTypeStateIssuer
204834204MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: william.drake.1@32440.direct.athenahealth.com

Organizations & group practices 1

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1255389920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 N MULBERRY DR",
            "address_2": "SUITE 150",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641161779",
            "telephone_number": "816-584-0505",
            "fax_number": "816-265-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 N MULBERRY DR",
            "address_2": "SUITE 150",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641161779",
            "telephone_number": "816-584-0505",
            "fax_number": "816-265-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "WILLIAM",
        "middle_name": "BAKER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "119862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204834204",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.