Madison Driggs Flake, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

342834 Issued in AZ

Practice address

22518 E Camina Buena Vis
Queen Creek, AZ 85142-9686

Phone

(801) 822-4621

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1326604083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22518 E CAMINA BUENA VIS",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429686",
            "telephone_number": "801-822-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22518 E CAMINA BUENA VIS",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429686",
            "telephone_number": "801-822-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAKE",
        "first_name": "MADISON",
        "middle_name": "DRIGGS",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "AZ",
            "license": "342834",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "AZ",
            "license": "342834",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "AZ",
            "license": "342834",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "342834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.