Kingfisher Clinic PLLC

Organization Active NPI Family Medicine Physician · Kingfisher, OK

NPI 1851780183 · NPPES record last updated May 5, 2021

Key facts

NPI
1851780183
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
KINGFISHER CLINIC PLLC
Practice address
1100 Hospital Cir
Kingfisher, OK 73750-5001
Phone
(281) 407-3018
NPI assigned
Jan 9, 2015
Organization subpart
No

Authorized official

Name
Dr. Robin L Matson, M.D.
Title
Owner/Operator
Phone
(281) 407-3018

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1097419Kingfisher Clinic PLLC
1100 Hospital Circle, Kingfisher, OK 73750
AccreditationSep 11, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150406001512 OK Part B Supplier - Clinic/Group Practice 9537487483 Receives reassigned benefits from 4 practitioners
Practice locations: Kingfisher, OK

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e0aed929-e53b-4d96-a40c-36cb9539f12f/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

1100 Hospital Cir
Kingfisher, OK 73750-5001

Mailing address

1100 Hospital Cir
Kingfisher, OK 73750-5001
Phone (281) 407-3018

Other names

  • Kingfisher Family Clinic Doing business as

Other providers in Kingfisher, OK

All providers in Kingfisher, OK · Family Medicine Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.