Individual provider Active NPI

Corey Michael Stubbs, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1033220918
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3657 Issued in OK
Practice address
9709 E 79TH St
Tulsa, OK 74133-4566
Phone
(918) 994-4000
Fax
(918) 994-4090
NPI assigned
Aug 31, 2006
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3657 OK Primary

Addresses

Primary practice location

9709 E 79TH St
Tulsa, OK 74133-4566

Mailing address

9709 E 79TH St
Tulsa, OK 74133-4566
Phone (918) 994-4048

Other practice location 1

601 S Mission St
Sapulpa, OK 74066-4657
Phone (918) 224-5900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@invictus.healthcare Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000481 OK Practitioner - Chiropractic 8527136126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Chiropractic Clinic Inc PCGroup PAC ID 9537326301, 2 clinicians

Practice addresses (Care Compare)

10115 E 80TH St
Suite B
Tulsa, OK 74133-3425
Phone (918) 893-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3657OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Chiropractic Clinic Inc PC Chiropractor CurrentSince May 1, 2025 Accepting new patients
Invictus Healthcare System, PLLC CurrentSince Aug 15, 2017 Accepting new patients
Stubbs, Inc. Chiropractor CurrentSince Mar 1, 2008 Accepting new patients
D S Lawrence DC, PC Chiropractor Past Accepting new patients

Locations

10115 E 80th St
Ste B
Tulsa, OK 74133
Phone (918) 893-6400

9709 E 79th St
Tulsa, OK 74133
Phone (918) 994-4000

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Interoperability endpoints

  • Direct secure messaging: corey.stubbs@invictus.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73165

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1033220918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4048",
            "fax_number": "918-994-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4000",
            "fax_number": "918-994-4090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Mission St",
            "address_purpose": "LOCATION",
            "city": "Sapulpa",
            "state": "OK",
            "postal_code": "740664657",
            "country_code": "US",
            "telephone_number": "918-224-5900",
            "fax_number": "918-224-6642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "COREY",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@invictus.healthcare",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "9709 E 79th St",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741334566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.