Nicole Drake

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

30307259 Issued in NY

Practice address

45 W Main St
Cuba, NY 14727-1403

Phone

(585) 968-1628

NPI assigned

Apr 9, 2015

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Olean General Hospital

  • General Practice Physician
  • Bradford, PA
  • NPI 1649296781

  Adult Health, NY

  Medicare reassignment NPD
• Olean General Hospital

  • General Practice Physician
  • Olean, NY
  • NPI 1033499017
  NPD

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1649666397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 WHITE OAK DR",
            "city": "ALLEGANY",
            "state": "NY",
            "postal_code": "147061136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W MAIN ST",
            "city": "CUBA",
            "state": "NY",
            "postal_code": "147271403",
            "telephone_number": "585-968-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30307259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Cusker, RN
• Leo Cusumano, M.D.
• Cloyd John Dean
• Brandy Anne Deckman
• Kathryn Degroff
• Denean Marie Emerson, D.C.
• Stacey Farris
• Michelle D Faulk
• Fillmore & Fisher Pharmacy, Inc
• First Transit, Inc.

• All providers in Cuba, NY
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.