Active NPI
Mallory Blaine Drake, MPH, RDN, LDN, CHES
- Registered Dietitian
- Philadelphia, PA
National Provider Identifier
1386334605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN007571
- Practice address
- 420 N 20TH St
Philadelphia, PA 19130-3828 - Phone
- (215) 496-2662
- NPI assigned
- May 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN007571 | PA | Primary |
Addresses
Primary practice location
420 N 20TH St
Philadelphia, PA 19130-3828
Mailing address
250 S Maple St Unit 2411
Ambler, PA 19002-5540
Phone (908) 872-2070
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN007571 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Area Neighborhood Nutrition Alliance | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Home Delivered Meals
- Philadelphia, PA
- NPI 1730399064
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1386334605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 S MAPLE ST UNIT 2411",
"city": "AMBLER",
"state": "PA",
"postal_code": "190025540",
"telephone_number": "908-872-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 N 20TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191303828",
"telephone_number": "215-496-2662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "MALLORY",
"middle_name": "BLAINE",
"credential": "MPH, RDN, LDN, CHES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-10",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN007571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.