Active NPI
Cori Valdene Phillips
- Counselor
- Tulsa, OK
National Provider Identifier
1174828107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- UNDER SUPERVISION
- Practice address
- 1704 E 73Rd St Apt 702
Tulsa, OK 74136-7410 - Phone
- (404) 895-6122
- NPI assigned
- Jan 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | UNDER SUPERVISION | Primary |
Addresses
Primary practice location
1704 E 73Rd St Apt 702
Tulsa, OK 74136-7410
Mailing address
1704 E 73Rd St Apt 702
Tulsa, OK 74136-7410
Phone (404) 895-6122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200385110 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1174828107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 E 73RD ST APT 702",
"city": "TULSA",
"state": "OK",
"postal_code": "741367410",
"telephone_number": "404-895-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 E 73RD ST APT 702",
"city": "TULSA",
"state": "OK",
"postal_code": "741367410",
"telephone_number": "404-895-6122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CORI",
"middle_name": "VALDENE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-23",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": "UNDER SUPERVISION",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200385110",
"state": "OK"
}
],
"endpoints": [],
"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 Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.