Individual provider Active NPI

Erica Kathleen Drake, NP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1366635302
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R-161262-0 Issued in MN
Practice address
516 Delaware St SE
4-100 PWB, Clinic 4a
Minneapolis, MN 55455-0356
Phone
(612) 626-6777
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R-161262-0 MN Primary

Addresses

Primary practice location

516 Delaware St SE
4-100 PWB, Clinic 4a
Minneapolis, MN 55455-0356

Mailing address

420 Delaware St SE
MMC 484
Minneapolis, MN 55455-0341
Phone (612) 626-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20080220000618 MN Practitioner - Nurse Practitioner 9537243134 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R-161262-0MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 14, 2007 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Aug 14, 2007 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients
West Side Community Health Services, Inc. Past Accepting new patients

Locations

19685 Pilot Knob Rd
Ste 100
Farmington, MN 55024
Phone (612) 355-8865

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

2450 Riverside Ave
Fl 9
Minneapolis, MN 55454
Phone (612) 365-8100

516 Delaware St SE
#4100
Minneapolis, MN 55455
Phone (612) 625-6964

420 Delaware St SE
#484
Minneapolis, MN 55455
Phone (612) 626-2778

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

Interoperability endpoints

  • Direct secure messaging: edrake147990@fairview.direct-ci.com
  • Direct secure messaging: edrake733042@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1366635302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 484",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-626-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "4-100 PWB, CLINIC 4A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-626-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "ERICA",
        "middle_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R-161262-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.