Shelby Nicole Drake, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

37003006A Issued in IN

Practice address

727 W 2ND St
Bloomington, IN 47403-2209

Phone

(812) 353-5704

NPI assigned

Mar 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1801422779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2692 S ADAMS ST APT 3",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034441",
            "telephone_number": "260-228-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032209",
            "telephone_number": "812-353-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "SHELBY",
        "middle_name": "NICOLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "86036774",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37003006A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle M. Doyle, MD
• Dr Kristina Morris LLC
• Dr Mark Lynn & Associates, PLLC
• Dr Randy L Carmichael
• Dr. Katy Kopp Miller, LLC
• Stephanie Drake
• Desirae Deniece Draluck, LMHC, MS
• Anika Drichel
• Drummond Chiropractic LLC
• Karin V Drummond, D.C.

• Registered Dietitian in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.