Mary Kathleen Drake, AUD CCCA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

7305 Issued in MN

Practice address

1104 7TH Ave South
Msum Box 119
Moorhead, MN 56563-0001

Phone

(218) 477-5953

Fax

(518) 477-4392

NPI assigned

Sep 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota State Colleges and UniversitiesGroup PAC ID 2264334663, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Minnesota State Colleges & Universities

  dba MSUM Speech Language and Hearing Clinic

  • Speech-Language Pathologist
  • Moorhead, MN
  • NPI 1215000963
  Medicare reassignment Care Compare group NPD
• Minnesota State Colleges and Universities

  dba Minnesota State University, Mankato

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mankato, MN
  • NPI 1104651355
  NPD
• Minnesota State Colleges & Universities

  dba MSUM Speech Language and Hearing Clinic

  • Audiologist
  • Moorhead, MN
  • NPI 1558421404
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346332947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 7TH AVE SOUTH",
            "address_2": "MSUM BOX 119",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565630001",
            "telephone_number": "218-477-5953",
            "fax_number": "518-477-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 7TH AVE SOUTH",
            "address_2": "MSUM BOX 119",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565630001",
            "telephone_number": "218-477-5953",
            "fax_number": "518-477-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "AUD CCCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "7305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22624",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "426S9DR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54228",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann Doyle, M.D.
• Kayla A Dragseth, LPC
• Drake Counseling Services
• Drake Counseling Services
• Drake Counseling Services, Inc.
• Sarah Drusch
• Sara Dukart, APRN
• Bill J Duke
• Denise M Duke, ED.D., LP
• Kristin Hannah Dukek

• Audiologist in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Audiologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.