1. Home
  2. Directory
  3. Oklahoma
  4. Edmond
  5. Clinic Center
  6. NPI Profile

COFFEE CREEK MEDICAL CLINIC
NPI 1699963264
Clinic/Center in Edmond, OK

Active since October 09, 2007
2820 N KELLY AVE, SUITE 200, EDMOND, OK 73003(405) 330-1478(405) 330-6231 Get Directions Write a Review

NPPES record last updated: February 4, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Coffee Creek Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COFFEE CREEK MEDICAL CLINIC (NPI 1699963264) is a healthcare organization registered as a clinic/center in Edmond, Oklahoma and active in the NPI registry since October 2007. The organization lists Timothy Brian Jones, Owner, as its authorized official.

NPPES Registry Identity

NPI1699963264
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameKICKINGBIRD FAMILY MEDICINE PLLC
Location Address2820 N KELLY AVE, SUITE 200Edmond, OK 73003-3007
Mailing AddressPo Box 31266Edmond, OK 73003-0022 · (405) 330-1478 · Fax (405) 330-6231
Phone(405) 330-1478
Fax(405) 330-6231
Organization SubpartNo
Authorized OfficialTimothy Brian JonesOwner · (405) 330-1478
Enumeration DateOctober 9, 2007
Last NPPES UpdateFebruary 4, 2008
✔ NPI 1699963264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
2820 N KELLY AVE, Edmond, OK 73003
Open in Google Maps ↗

Other Names 1

Doing Business AsCoffee Creek Medical Clinic

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KIMBERLY EDGMON M.D.
Pediatrics
2820 N KELLY AVE, SUITE 200
EDMOND, OK 73003
Oklahoma County (405) 726-8000
TAMMY MASCHINO, MD PLLC
Pediatrics
2820 N KELLY AVE, SUITE 200
EDMOND, OK 73003
Oklahoma County (405) 726-8000
KIMBERLY EDGMON MD, PLLC
Pediatrics
2820 N KELLY AVE, SUITE 200
EDMOND, OK 73003
Oklahoma County (405) 726-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kickingbird Family Medicine PLLC's NPI number?

The NPI number for Kickingbird Family Medicine PLLC is 1699963264. It was assigned to this organization in the NPPES registry on October 9, 2007. The provider is doing business as Coffee Creek Medical Clinic.

Where is Kickingbird Family Medicine PLLC located?

Kickingbird Family Medicine PLLC is located at 2820 N Kelly Ave Suite 200, Edmond, OK 73003. The listed phone number is (405) 330-1478.

What is Kickingbird Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Kickingbird Family Medicine PLLC was last updated on February 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.