Individual provider Active NPI

David Todd Drake, APRN, FNP-C

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1366288946
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219034 Issued in OK
Practice address
12697 E 51St St
Tulsa, OK 74146-6236
Phone
(918) 505-3200
NPI assigned
Jul 3, 2024
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219034 OK Primary

Addresses

Primary practice location

12697 E 51St St
Tulsa, OK 74146-6236

Mailing address

9707 S 228TH East Ave
Broken Arrow, OK 74014-6846
Phone (918) 718-4774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903001628 OK Practitioner - Nurse Practitioner 8123567237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12697 E 51St St
Tulsa, OK 74146-6236

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
219034OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Jul 3, 2024 Accepting new patients
Tulsa Cancer Institute PLLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC CurrentSince Jul 3, 2024 Accepting new patients

Locations

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1366288946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9707 S 228TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146846",
            "telephone_number": "918-718-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-505-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "DAVID",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "219034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.