Individual provider Active NPI

Corey Starks, MOTR

  • Occupational Therapist
  • Tyler, TX
National Provider Identifier
1336337674
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
112295 Issued in TX
Practice address
3414 Golden Rd
Tyler, TX 75701
Phone
(903) 939-7599
NPI assigned
Oct 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 112295 TX Primary

Addresses

Primary practice location

3414 Golden Rd
Tyler, TX 75701

Mailing address

3414 Golden Rd
Tyler, TX 75701-8336
Phone (903) 939-7599

Other practice location 1

3505 Old Jacksonville Rd
Tyler, TX 75701-8510
Phone (903) 561-2011

Other practice location 2

3505 Old Jacksonville Rd
Tyler, TX 75701-8510
Phone (903) 561-2011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140523001982 TX Practitioner - Occupational Therapist in Private Practice 2860615689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Texas Medical Branch at Galveston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

3414 Golden Rd
Tyler, TX 75701-8336
Phone (903) 939-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112295TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

3414 Golden Rd
Tyler, TX 75701
Phone (903) 590-3050

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1336337674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018336",
            "telephone_number": "903-939-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-939-7599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 Old Jacksonville Rd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018510",
            "country_code": "US",
            "telephone_number": "903-561-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3505 Old Jacksonville Rd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018510",
            "country_code": "US",
            "telephone_number": "903-561-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARKS",
        "first_name": "COREY",
        "credential": "MOTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.