Active NPI
Terrance Stephen Drake, MD
- Adult Medicine Physician
- Highland, UT
National Provider Identifier
1811262280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 7584822-1205
- Practice address
- 5563 Coventry Rd
Highland, UT 84003-3473 - Phone
- (801) 216-4581
- NPI assigned
- Mar 18, 2012
- Last updated
- Mar 18, 2012
- 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 |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 7584822-1205 | UT | Primary |
Addresses
Primary practice location
5563 Coventry Rd
Highland, UT 84003-3473
Mailing address
5563 Coventry Rd
Highland, UT 84003-3473
Phone (801) 216-4581
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7584822-1205 | UT | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332028800000",
"number": "1811262280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5563 COVENTRY RD",
"city": "HIGHLAND",
"state": "UT",
"postal_code": "840033473",
"telephone_number": "801-216-4581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5563 COVENTRY RD",
"city": "HIGHLAND",
"state": "UT",
"postal_code": "840033473",
"telephone_number": "801-216-4581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "TERRANCE",
"middle_name": "STEPHEN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-18",
"last_updated": "2012-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "UT",
"license": "7584822-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.