Individual provider Active NPI

Cori Elena Wadley, P.A.

  • Physician Assistant
  • Yukon, OK
National Provider Identifier
1477765501
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1519 Issued in OK
Practice address
1616 S Mustang Rd
Yukon, OK 73099-0304
Phone
(405) 256-0501
Fax
(405) 265-1611
NPI assigned
May 3, 2007
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1519 OK Primary

Addresses

Primary practice location

1616 S Mustang Rd
Yukon, OK 73099-0304

Mailing address

1616 S Mustang Rd
Yukon, OK 73099-0304
Phone (405) 256-0501

Other practice location 1

2804 SW 134th St
Oklahoma City, OK 73170-5474
Phone (405) 676-8608

Other practice location 2

12000 Charleston Way
Yukon, OK 73099-9587
Phone (405) 883-1119

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000536 OK Practitioner - Physician Assistant 8628124641 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medok Mustang, LLCGroup PAC ID 7810288032, 11 clinicians
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

12000 Charleston Way
Yukon, OK 73099-9587
Phone (405) 883-1119

1616 S Mustang Rd
Yukon, OK 73099-0304
Phone (405) 256-0501

18961 NE 23Rd St
Harrah, OK 73045-8109
Phone (405) 390-1800

2804 SW 134TH St
Oklahoma City, OK 73170-5474
Phone (405) 676-8608

3345 Territory LN
El Reno, OK 73036-6503
Phone (405) 218-2530

608 NW 9TH St
Oklahoma City, OK 73102-1049

999 Hospital Dr
Purcell, OK 73080-1742
Phone (405) 803-5010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Purcell Municipal Hospital CurrentSince Mar 20, 2016 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 13, 2024 Accepting new patients
Medok South May LLC CurrentSince Oct 12, 2025 Accepting new patients
Oca Tricity LP Past Accepting new patients
Oca 1 LLC Past Accepting new patients

Locations

2804 SW 134th St
Oklahoma City, OK 73170
Phone (405) 675-8608

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

1500 N Green Ave
Purcell, OK 73080
Phone (405) 527-2250

12000 Charleston Way
Yukon, OK 73099
Phone (405) 883-1119

1616 S Mustang Rd
Yukon, OK 73099
Phone (405) 256-0501

Organizations & group practices 9

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1477765501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730990304",
            "telephone_number": "405-256-0501",
            "fax_number": "405-265-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730990304",
            "telephone_number": "405-256-0501",
            "fax_number": "405-265-1611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2804 SW 134th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731705474",
            "country_code": "US",
            "telephone_number": "405-676-8608",
            "fax_number": "405-676-8631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12000 Charleston Way",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "730999587",
            "country_code": "US",
            "telephone_number": "405-883-1119",
            "fax_number": "405-883-1135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "CORI",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.