NPIMap

Individual provider Active NPI

Kari Ann Drake, PA-C

  • Physician Assistant
  • Bigfork, MN
National Provider Identifier
1932414935
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10796 Issued in MN
Practice address
135 Pine Tree Dr
Bigfork, MN 56628
Phone
(218) 743-3232
NPI assigned
Aug 13, 2010
Last updated
Jun 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1465 MN
Physician Assistant 363A00000X 10796 MN Primary

Addresses

Primary practice location

135 Pine Tree Dr
Bigfork, MN 56628

Mailing address

135 Pine Tree Dr
Bigfork, MN 56628
Phone (218) 743-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118001417 MN Practitioner - Physician Assistant 6204022031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook Area Health Services, IncGroup PAC ID 4880681303, 27 clinicians

Practice addresses (Care Compare)

135 Pine Tree Dr
Bigfork, MN 56628-0135
Phone (218) 743-3232

135 Pine Tree Dr
Bigfork, MN 56628-4346

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1465MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Area Health Services, Inc CurrentSince Sep 11, 2010 Accepting new patients
Northern Itasca Hospital District CurrentSince Sep 11, 2010 Accepting new patients
Cook Area Health Services, Inc Family Medicine Current Accepting new patients
Cook Area Health Services, Inc CurrentSince Sep 11, 2010 Accepting new patients
Cook Area Health Services, Inc Past Accepting new patients

Locations

410 2nd St NW
Big Falls, MN 56627
Phone (218) 276-2403

135 Pine Tree Dr
Bigfork, MN 56628
Phone (218) 743-3232

20 5th St SE
Cook, MN 55723
Phone (218) 666-5941

12052 Main St
Northome, MN 56661
Phone (218) 897-5222

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1932414935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PINE TREE DR",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PINE TREE DR",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "KARI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-13",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1465",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bigfork, MN

Sources for this page

Verify at the official NPI Registry.