Phillip Wade Corley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4868 Issued in OK

Practice address

4200 W Memorial Rd
#507
Oklahoma City, OK 73120-9350

Phone

(405) 751-0018

Fax

(405) 751-0671

NPI assigned

Sep 12, 2006

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

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376647099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "#507",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-751-0018",
            "fax_number": "405-751-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "#507",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-751-0018",
            "fax_number": "405-751-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "PHILLIP",
        "middle_name": "WADE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey E. Mayo D.O. PLLC
• Karen E. Corff, ARNP
• Amber Coriano
• Corlee Foot & Ankle
• N Bryce Andrew Corlee, DPM
• Stanley D. Corley, M.D.
• Terra Corley
• Carolyn Ruth Corn, M.D.
• Jessica Cornelius Smith, MS, BS
• Karley Cornelius, MHR, LPC

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.