Corey Du Juan Starks

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

License

1049220 Issued in AZ

Practice address

4880 N Sabino Canyon Rd Apt 4219
Tucson, AZ 85750-7008

Phone

(816) 956-1487

NPI assigned

Jan 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Crossing Arrows Counseling Services

  • Addiction (Substance Use Disorder) Counselor
  • Tucson, AZ
  • NPI 1720603343
  NPD Authorized official
• Starks Homes LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Vail, AZ
  • NPI 1518331057
  NPD Authorized official
• Starks Homes LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Tucson, AZ
  • NPI 1538668983
  NPD Authorized official

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1225275191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 N SABINO CANYON RD APT 4219",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507008",
            "telephone_number": "816-956-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 N SABINO CANYON RD APT 4219",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507008",
            "telephone_number": "816-956-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARKS",
        "first_name": "COREY",
        "middle_name": "DU JUAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "1049220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Stark, M.D.
• Donna Colleen Stark, M.D.
• Stephanie Daisy Stark, N.M.D
• Suzanne Margaret Starkey, MS
• Starks Homes LLC
• Isela Starks
• Loren Starks, L.AC.
• Starling Oncology Ca, a Professional Corporation
• Starling Oncology Ca, a Professional Corporation
• Brenia Starnes

• Child Mental Illness Respite Care in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Child Mental Illness Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.