Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek R Flake, PT

Individual provider Physical Therapist · NPI 1104154269

Derek R Flake, PT is a Physical Therapist in Private Practice in Lakeside, Arizona. Qualified in 2009, 17 years ago. Practices with White Mountain Physical Therapy Ltd, a 15-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
17
Licensed in
AZ
In the registry since
2009
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

4830 Highway 260 Ste 105
Lakeside, AZ 85929-5851
Phone: (928) 532-1221
Fax: (928) 532-1227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 8520PT (AZ)

Record details

NPI number1104154269
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedDecember 1, 2009
Last updated in NPPESMarch 16, 2020
Certification dateMarch 16, 2020
Mailing addressPo Box 1420, Show Low, AZ 85902-1420

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice White Mountain Physical Therapy Ltd — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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