Organization Active NPI

Dr. Cody Drake PA

  • Foot & Ankle Surgery Podiatrist
  • Madison, NC
National Provider Identifier
1841542396
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
DR. CODY DRAKE PA
Practice address
107 W Decatur St
Madison, NC 27025-1907
Phone
(276) 632-5280
Fax
(276) 632-5257
NPI assigned
Oct 9, 2012
Last updated
Aug 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Dr. Cody Drake, DPMNPI 1649271602
Title
Owner
Phone
(276) 632-5280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

107 W Decatur St
Madison, NC 27025-1907

Mailing address

15 Cleveland Ave
Suite 9
Martinsville, VA 24112-2937
Phone (276) 632-5280

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121120000470 VA Part B Supplier - Clinic/Group Practice 0446401558 Receives reassigned benefits from 1 practitioner
Practice locations: Martinsville, VA
O20130903000149 NC Part B Supplier - Clinic/Group Practice 0446401558 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, NC

National Provider Directory

National Provider Directory

Locations

107 W Decatur St
Madison, NC 27025
Phone (336) 548-4480

15 Cleveland Ave
Ste 9
Martinsville, VA 24112
Phone (276) 632-5280

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1841542396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CLEVELAND AVE",
            "address_2": "SUITE 9",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122937",
            "telephone_number": "276-632-5280",
            "fax_number": "276-632-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W DECATUR ST",
            "city": "MADISON",
            "state": "NC",
            "postal_code": "270251907",
            "telephone_number": "276-632-5280",
            "fax_number": "276-632-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CODY DRAKE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-632-5280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.