Individual provider Active NPI

Shawn M Drake, PT

  • Physical Therapist
  • Mobile, AL
National Provider Identifier
1790080513
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH10871 Issued in AL
Practice address
5721 USA Dr N Hahn 2017
Mobile, AL 36688-0001
Phone
(251) 445-9378
Fax
(251) 445-9377
NPI assigned
Jan 26, 2011
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2965 AR
Physical Therapist 225100000X PTH10871 AL Primary

Addresses

Primary practice location

5721 USA Dr N Hahn 2017
Mobile, AL 36688-0001

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (372) 268-6430

Other practice location 1

2912 Browns Ln Ste C
Jonesboro, AR 72401
Phone (870) 897-3420

Other practice location 2

450 S 9th Ave
Piggott, AR 72454-2501
Phone (870) 598-2291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202001557 AL Practitioner - Physical Therapist in Private Practice 3971979733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

307 N University Blvd
Suite 170
Mobile, AL 36688-0002

75 S University Blvd
Unit 6000
Mobile, AL 36608-3274
Phone (251) 660-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2965ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince Sep 9, 2022 Accepting new patients
USA Health Physician Billing Services LLC Physical Therapist CurrentSince Sep 9, 2022 Accepting new patients

Locations

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1790080513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "372-268-6430",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 USA DR N HAHN 2017",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366880001",
            "telephone_number": "251-445-9378",
            "fax_number": "251-445-9377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2912 Browns Ln Ste C",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "72401",
            "country_code": "US",
            "telephone_number": "870-897-3420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 S 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Piggott",
            "state": "AR",
            "postal_code": "724542501",
            "country_code": "US",
            "telephone_number": "870-598-2291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "SHAWN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2965",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH10871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.