Charles Drake, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

012789 Issued in NY

Practice address

714 E Park Ave
Long Beach, NY 11561-2625

Phone

(516) 323-9145

NPI assigned

Jun 8, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2000

Medicare assignment

May accept Medicare assignment

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 and National Provider Directory roles.

• East Park Chiropractic Wellness PC

  • Chiropractor
  • Long Beach, NY
  • NPI 1700451093
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1568086387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E PARK AVE # 421",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613521",
            "telephone_number": "516-323-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612625",
            "telephone_number": "516-323-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "CHARLES",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Downing, M.S.
• Brian Doyle
• Dr Kenneth Katz
• Dr. Leon Katz Obesity, PLLC
• Dr. Patrick E. McManus
• Lillian Drake, R.N.
• DRS. H and M Briffel
• Valerie Josee Duca, RPH
• Robyn Duhl, CCC-SLP
• Chelsea Dukes, CFY-SLP

• Chiropractor in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.