Organization Active NPI

J Coffey MD PC

  • Family Medicine Physician
  • Elk City, OK
National Provider Identifier
1386755072
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20836 Issued in OK
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

Updated by the provider on Jan 30, 2026

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
100136650AMedicaidOK
20836OtherOKMEDICAL LICENSE NUMBER
37D0963547OtherOKCLIA WAIVER NUMBER
448604592-001OtherOKBC BS OF OK PROVIDER ID
100136650DMedicaidOK
100136650CMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070420000226 OK Part B Supplier - Clinic/Group Practice 8628173556 Receives reassigned benefits from 1 practitioner
Practice locations: Elk City, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0963547J Coffey MD PC1900 West 2ND Street, Suite C, Elk City, OK 73644Certificate of waiverAug 1, 2027

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.