Matthew C. Drake, ATC, CMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

37650 Professional Center Dr
Suite 105a
Livonia, MI 48154-1197

Phone

(734) 953-1745

Fax

(734) 953-1743

NPI assigned

Jul 22, 2009

Last updated

Jul 22, 2009By the provider in NPPES

Sex

Male

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)

Not enrolled

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1902036114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 105A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 105A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "MATTHEW",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "ATC, CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Livonia, MI
• Providers in Livonia, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.