Active NPI
Denise Marie Drake, BS OT
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1518150358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31004693A
- Practice address
- 5949 W Raymond St
Indianapolis, IN 46241-4348 - Phone
- (317) 390-5575
- Fax
- (317) 486-2189
- NPI assigned
- Aug 24, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 5527 | OH | |
| Occupational Therapist | 225X00000X | 31004693A | IN | Primary |
Addresses
Primary practice location
5949 W Raymond St
Indianapolis, IN 46241-4348
Mailing address
790 Remington Blvd.
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200922680 | Medicaid | IN | |
| P01023494 | Other | IN | MEDIDCARE RR |
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)
- Enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5527 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337817600000",
"number": "1518150358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD.",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "317-486-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5949 W RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462414348",
"telephone_number": "317-390-5575",
"fax_number": "317-486-2189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "DENISE",
"middle_name": "MARIE",
"credential": "BS OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-24",
"last_updated": "2012-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "OH",
"license": "5527",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31004693A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200922680",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDIDCARE RR",
"identifier": "P01023494",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.