Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kickingbird Family Medicine PLLC

Organization Clinic/Center · NPI 1699963264

Kickingbird Family Medicine PLLC is a Clinic/Center in Edmond, Oklahoma. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2820 N Kelly Ave Ste 200
Edmond, OK 73003-3007
Phone: (405) 330-1478
Fax: (405) 330-6231
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1699963264
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Jones — Owner · (405) 330-1478
Other names Coffee Creek Medical Clinic
NPI enumeratedOctober 9, 2007
Last updated in NPPESFebruary 4, 2008
Mailing addressPo Box 31266, Edmond, OK 73003-0022

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