Joshua Derrell Corley, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1538 Issued in OK

Practice address

721 Better Now PLZ
Ada, OK 74820-2279

Phone

(580) 272-0025

Fax

(580) 272-6659

NPI assigned

May 22, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336194208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 ARLINGTON CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202883",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 12th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Ardmore",
            "state": "OK",
            "postal_code": "734011206",
            "country_code": "US",
            "telephone_number": "580-226-8646",
            "fax_number": "580-226-8641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "JOSHUA",
        "middle_name": "DERRELL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA1538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "245617201",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAL LICENSE",
            "identifier": "PA1538",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20083400A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Debra J Cox, IBCLC,RLC

• Medical Physician Assistant in Ada, OK
• Providers in Ada, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.