Individual provider Active NPI

Jennifer Drake

  • Physical Therapist
  • Matthews, NC
National Provider Identifier
1760873384
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8418 Issued in SC
Practice address
2008 Moore Rd
Matthews, NC 28105-4978
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Feb 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8418 SC Primary

Addresses

Primary practice location

2008 Moore Rd
Matthews, NC 28105-4978

Mailing address

385 Spears Creek Church Rd Ste B
Elgin, SC 29045-8446
Phone (803) 929-7408

Other practice location 1

385 Spears Creek Church Rd Ste B
Elgin, SC 29045-8446
Phone (803) 929-7408

Other identifiers 1

IdentifierTypeStateIssuer
8418OtherSCPHYSICAL THERAPY LICENSES

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT NC LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200317001665 SC Practitioner - Physical Therapist in Private Practice 4385072826 Reassigns benefits to 1 organization
I20250310000052 NC Practitioner - Physical Therapist in Private Practice 4385072826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services of South Carolina, LLCGroup PAC ID 3971639998, 289 clinicians

Practice addresses (Care Compare)

800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services of South Carolina, LLC Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
Fox Rehab PT NC LLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients

Locations

2008 Moore Rd
Matthews, NC 28105

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1760873384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 SPEARS CREEK CHURCH RD STE B",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290458446",
            "telephone_number": "803-929-7408",
            "fax_number": "888-711-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 MOORE RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054978",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 Spears Creek Church Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "SC",
            "postal_code": "290458446",
            "country_code": "US",
            "telephone_number": "803-929-7408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSES",
            "identifier": "8418",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT NC LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2008 Moore Rd",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281054978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.