Individual provider Active NPI

Cody M Drake, DPM

  • Foot & Ankle Surgery Podiatrist
  • Martinsville, VA
National Provider Identifier
1649271602
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103000961 Issued in VA
Practice address
15 Cleveland Ave
Suite 9
Martinsville, VA 24112-2937
Phone
(276) 632-5280
Fax
(276) 632-5257
NPI assigned
Aug 2, 2005
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 304 NC
Foot & Ankle Surgery Podiatrist 213ES0103X 0103000961 VA Primary

Addresses

Primary practice location

15 Cleveland Ave
Suite 9
Martinsville, VA 24112-2937

Mailing address

15 Cleveland Ave
Suite 9
Martinsville, VA 24112-2937
Phone (276) 632-5280

Other practice location 1

107 W Decatur St
Madison, NC 27025-1907
Phone (336) 548-4480

Other identifiers 1

IdentifierTypeStateIssuer
890812EMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100527000126 VA Practitioner - Podiatry 4486783610 Reassigns benefits to 1 organization
I20101208000301 NC Practitioner - Podiatry 4486783610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

107 W Decatur St
Madison, NC 27025-1907
Phone (336) 548-4800

15 Cleveland Ave
Suite 9
Martinsville, VA 24112-2937
Phone (276) 632-5280

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue82
Removal of skin lesions14
Removal of nail tissue1452
Removal or shaving of skin growth1049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
304NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Cody Drake PA Foot & Ankle Surgery CurrentSince Oct 1, 2012 Accepting new patients
Dr. Cody Drake's Office Foot & Ankle Surgery PastSince Jun 29, 2013 Accepting new patients

Locations

107 W Decatur St
Madison, NC 27025
Phone (336) 548-4800

15 Cleveland Ave
Ste 9
Martinsville, VA 24112
Phone (276) 632-5280

Organizations & group practices 3

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 3

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1649271602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CLEVELAND AVE",
            "address_2": "SUITE 9",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122937",
            "telephone_number": "276-632-5280",
            "fax_number": "276-632-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CLEVELAND AVE",
            "address_2": "SUITE 9",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122937",
            "telephone_number": "276-632-5280",
            "fax_number": "276-632-5257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 W Decatur St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "NC",
            "postal_code": "270251907",
            "country_code": "US",
            "telephone_number": "336-548-4480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "CODY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "304",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103000961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890812E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.