Individual provider Active NPI

Kathleen M. Drake, D.C.

  • Chiropractor
  • Federal Way, WA
National Provider Identifier
1881780328
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033821 Issued in WA
Practice address
33650 6TH Ave S
Suite 100
Federal Way, WA 98003-6754
Phone
(253) 942-3300
Fax
(253) 815-8805
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033821 WA Primary

Addresses

Primary practice location

33650 6TH Ave S
Suite 100
Federal Way, WA 98003-6754

Mailing address

33650 6TH Ave S
Suite 100
Federal Way, WA 98003-6754
Phone (253) 942-3300

Other identifiers 1

IdentifierTypeStateIssuer
0201158OtherWADEPT. OF L&I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726002466 AZ Practitioner - Chiropractic 5698712701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pentz Health Services LLCGroup PAC ID 1557392214, 7 clinicians

Practice addresses (Care Compare)

6402 E Superstition Springs Blvd
Suite 123
Mesa, AZ 85206-4391
Phone (480) 833-0302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pentz Health Services LLC Chiropractor CurrentSince Aug 1, 2022 Accepting new patients
Lake Meridian Chiropractic Chiropractor PastSince Apr 18, 2014 Accepting new patients
Infinite Health & Wellness Centers PLLC Chiropractor PastSince Aug 1, 2022 Accepting new patients
Starbright Tamarack Chiropractor Past Accepting new patients

Locations

6402 E Superstition Springs Blvd
Ste 123
Mesa, AZ 85206
Phone (480) 794-1061

Organizations & group practices 4

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1881780328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33650 6TH AVE S",
            "address_2": "SUITE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036754",
            "telephone_number": "253-942-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33650 6TH AVE S",
            "address_2": "SUITE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036754",
            "telephone_number": "253-942-3300",
            "fax_number": "253-815-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF L&I",
            "identifier": "0201158",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.