Jordyn Audrey Drake, DO is a medicare enrolled "Family Medicine" physician in Peterson Sfb, Colorado. Her current practice location is
559 Vincent St, Space Base Delta 1, Peterson Sfb, Colorado. You can reach out to her office (for appointments etc.) via phone at
(217) 208-9232.
Jordyn Audrey Drake is licensed to practice in Illinois (license number 125077767) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114599370.
Physician's Profile
Full Name | Jordyn Audrey Drake |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 559 Vincent St, Peterson Sfb, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1114599370
- Provider Enumeration Date: 07/15/2021
- Last Update Date: 07/23/2025
Medicare PECOS Information:
- PECOS PAC ID: 0244638401
- Enrollment ID: I20211004000130
Medical Identifiers
Medical identifiers for Jordyn Audrey Drake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114599370 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 125077767 (Illinois) | Primary |
207Q00000X | Family Medicine | 036171403 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordyn Audrey Drake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jordyn Audrey Drake, DO 559 Vincent St, Space Base Delta 1, Peterson Sfb, CO 80914 Ph: (217) 208-9232 | Jordyn Audrey Drake, DO 559 Vincent St, Space Base Delta 1, Peterson Sfb, CO 80914 Ph: (217) 208-9232 |
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