Active NPI
Jeremiah Drake
- Registered Nurse
- Madison, TN
National Provider Identifier
1720758444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 234551
- Practice address
- 315 Hospital Dr
Madison, TN 37115-5030 - Phone
- (419) 494-6057
- NPI assigned
- Sep 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 234551 | TN | Primary |
Addresses
Primary practice location
315 Hospital Dr
Madison, TN 37115-5030
Mailing address
107 Havenwood CT
Hendersonville, TN 37075-7208
Phone (419) 494-6057
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234551 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1720758444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 HAVENWOOD CT",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370757208",
"telephone_number": "419-494-6057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 HOSPITAL DR",
"city": "MADISON",
"state": "TN",
"postal_code": "371155030",
"telephone_number": "419-494-6057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "JEREMIAH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "234551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.