Mick Gene Drage, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2585 Issued in AZ

Practice address

1515 S 20TH Ave
Safford, AZ 85546-4009

Phone

(928) 348-1370

Fax

(928) 348-1375

NPI assigned

May 4, 2006

Last updated

Jan 27, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gregg P Standage MD

  • Specialist
  • Prescott, AZ
  • NPI 1235416918
  NPD (past)
• Gregg P Standage MD

  • Specialist
  • Safford, AZ
  • NPI 1669495537
  NPD (past)
• Walker Family Medicine PLC

  • Family Medicine Physician
  • Willcox, AZ
  • NPI 1194907758
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1710935499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464009",
            "telephone_number": "928-348-1370",
            "fax_number": "928-348-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464009",
            "telephone_number": "928-348-1370",
            "fax_number": "928-348-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGE",
        "first_name": "MICK",
        "middle_name": "GENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "639354",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Dobbs
• Kami Lyn Dolan, RN
• Douglas G. Harrison MD, PC (DBA Rex OBGYN)
• Dovetree Counseling Associates, Inc.
• Dovetreecounseling Associates, Inc.
• Kimberly Ann Draper, LPC
• DSW Enterprises Inc (Walton Drug)
• Alexander Eddo, PHAMD
• Eden Home Health of Safford, LLC (Eden Home Health)
• Eden Hospice at Sierra Vista, LLC (Eden Hospice)

• Physician Assistant in Safford, AZ
• Providers in Safford, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.

Verify at the official NPI Registry.