Organization Active NPI

Kingfisher Clinic PLLC

Doing business as Kingfisher Family Clinic

  • Family Medicine Physician
  • Kingfisher, OK
National Provider Identifier
1851780183
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KINGFISHER CLINIC PLLC
Doing business as
Kingfisher Family Clinic
Practice address
1100 Hospital Cir
Kingfisher, OK 73750-5001
Phone
(281) 407-3018
NPI assigned
Jan 9, 2015
Last updated
May 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robin L Matson, M.D.NPI 1154378644
Title
Owner/Operator
Phone
(281) 407-3018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

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 1

  • Kingfisher Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150406001512 OK Part B Supplier - Clinic/Group Practice 9537487483 Receives reassigned benefits from 4 practitioners
Practice locations: Kingfisher, 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
37D1097419Kingfisher Clinic PLLC1100 Hospital Circle, Kingfisher, OK 73750AccreditationSep 11, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1851780183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HOSPITAL CIR",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737505001",
            "telephone_number": "281-407-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HOSPITAL CIR",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737505001",
            "telephone_number": "281-407-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGFISHER CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "MATSON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "281-407-3018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingfisher Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kingfisher Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingfisher, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.