Active NPI
Corey James Stotts, MD
- Anesthesiology Physician
- Dubuque, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 41108
- Practice address
- 1440 S Grandview Ave
Dubuque, IA 52003-8733 - Phone
- (319) 290-2097
- NPI assigned
- Apr 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 51179 | KY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 41108 | IA | Primary |
Addresses
Primary practice location
1440 S Grandview Ave
Dubuque, IA 52003-8733
Mailing address
1440 S Grandview Ave
Dubuque, IA 52003-8733
Phone (319) 290-2097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 299-9906
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP327 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Anesthesiology Group PC | Anesthesiology | Current | Accepting new patients |
| Dodge Street Anesthesiologists PC | Anesthesiology | Past | Accepting new patients |
Locations
707 SW Washington St
Ste 700
Portland, OR 97205
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
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.
-
- Anesthesiology Physician
- Portland, OR
- NPI 1477527786
-
- Anesthesiology Physician
- Dubuque, IA
- NPI 1972533040
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1619110426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 S GRANDVIEW AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520038733",
"telephone_number": "319-290-2097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 S GRANDVIEW AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520038733",
"telephone_number": "319-290-2097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOTTS",
"first_name": "COREY",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-08",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "51179",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IA",
"license": "41108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.
- 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.