Eagle Community Clinic LLC
NPI 1063790202 · Family Medicine Physician · Edmond, OK
Eagle Community Clinic LLC is a Family Medicine Physician organization in Edmond, OK (NPI 1063790202).
Provider details
- NPI number
- 1063790202
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Oklahoma Sports and Orthopedics Institute PLLC
- Organization subpart
- Yes
- Authorized official
- Brandon Penick, Director of Reimbursement(405) 360-6764
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-07-21
- Last updated
- 2011-07-21
Frequently asked questions
- What is Eagle Community Clinic LLC's NPI number?
- Eagle Community Clinic LLC's National Provider Identifier (NPI) is 1063790202, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Eagle Community Clinic LLC?
- Eagle Community Clinic LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Eagle Community Clinic LLC located?
- Eagle Community Clinic LLC's practice location on file with NPPES is 13800 Benson Rd, Edmond, OK 73013-6422.
- What is Eagle Community Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Eagle Community Clinic LLC is (405) 418-3077.
- Who is the authorized official for Eagle Community Clinic LLC?
- The authorized official listed on Eagle Community Clinic LLC's NPPES record is Brandon Penick, Director of Reimbursement. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Eagle Community Clinic LLC's NPI active?
- Yes — Eagle Community Clinic LLC's NPI (1063790202) is active in the NPPES registry as of the last update on 2011-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.