Active NPI
J Coffey MD PC
- Family Medicine Physician
- Elk City, OK
National Provider Identifier
1386755072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20836
- Legal business name
- J COFFEY MD PC
- Practice address
- 1900 W 2ND St
Suite C
Elk City, OK 73644-4328 - Phone
- (580) 225-9222
- Fax
- (580) 225-1027
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sally Ann Coffey
- Title
- Office Manager
- Phone
- (580) 225-9222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20836 | OK | Primary |
Addresses
Primary practice location
1900 W 2ND St
Suite C
Elk City, OK 73644-4328
Mailing address
1900 W 2ND St Ste C
Elk City, OK 73644-4328
Phone (580) 225-9222
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100136650A | Medicaid | OK | |
| 20836 | Other | OK | MEDICAL LICENSE NUMBER |
| 37D0963547 | Other | OK | CLIA WAIVER NUMBER |
| 448604592-001 | Other | OK | BC BS OF OK PROVIDER ID |
| 100136650D | Medicaid | OK | |
| 100136650C | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0963547 | J Coffey MD PC | Certificate of waiver | Aug 1, 2027 |
National Provider Directory
National Provider DirectoryLocations
1900 W 2nd St
Ste C
Elk City, OK 73644
Phone (580) 225-9222
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Elk City, OK
- NPI 1013045913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769731200000",
"number": "1386755072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 W 2ND ST STE C",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736444328",
"telephone_number": "580-225-9222",
"fax_number": "866-835-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 W 2ND ST",
"address_2": "SUITE C",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736444328",
"telephone_number": "580-225-9222",
"fax_number": "580-225-1027"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "J COFFEY MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2026-01-30",
"certification_date": "2026-01-30",
"status": "A",
"authorized_official_last_name": "COFFEY",
"authorized_official_first_name": "SALLY",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "580-225-9222"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OK",
"license": "20836",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100136650A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "20836",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA WAIVER NUMBER",
"identifier": "37D0963547",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF OK PROVIDER ID",
"identifier": "448604592-001",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100136650D",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100136650C",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elk City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; 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.