Individual provider Active NPI

Lyle Drake, AUD

  • Audiologist
  • Newnan, GA
National Provider Identifier
1760894737
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD003964 Issued in GA
Practice address
2080 Newnan Crossing Blvd
Suite 300
Newnan, GA 30265
Phone
(770) 955-0270
Fax
(770) 955-0271
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD003964 GA Primary

Addresses

Primary practice location

2080 Newnan Crossing Blvd
Suite 300
Newnan, GA 30265

Mailing address

1601 Georgian Park
Ste 100
Peachtree City, GA 30269-6968
Phone (770) 955-0270

Other practice location 1

1601 Georgian Park
Ste 100
Peachtree City, GA 30269-6968
Phone (770) 955-0270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626001256 GA Practitioner - Qualified Audiologist 7719102292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
N Hadley Heindel III, MD, LLCGroup PAC ID 1658655238, 4 clinicians

Practice addresses (Care Compare)

2080 Newnan Crossing Blvd E
Suite 300
Newnan, GA 30265-2555
Phone 7709550270109

Merit-based Incentive Payment System (MIPS)

Final score
91 of 100Reported as group
Quality
90
Promoting interoperability
99
Improvement activities
40
Cost
80.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD003964GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
N Hadley Heindel III, MD, LLC CurrentSince Jan 1, 2017 Accepting new patients
James G. Burson, MD, LLC Past Accepting new patients

Locations

2080 Newnan Crossing Blvd E
Ste 300
Newnan, GA 30265
Phone (770) 955-0270

1601 Georgian Park
#100
Peachtree Cty, GA 30269
Phone (770) 955-0270

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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1760894737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GEORGIAN PARK",
            "address_2": "STE 100",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696968",
            "telephone_number": "770-955-0270",
            "fax_number": "770-955-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 NEWNAN CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "770-955-0270",
            "fax_number": "770-955-0271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 GEORGIAN PARK",
            "address_2": "STE 100",
            "address_purpose": "LOCATION",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696968",
            "country_code": "US",
            "telephone_number": "770-955-0270",
            "fax_number": "770-955-0271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "LYLE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.