Eagle Community Clinic LLC
NPI 1063790202ActiveOrganization· Family Medicine· Edmond, OK
Family Medicine in Edmond, Oklahoma, registered in NPPES in July 2011, part of Oklahoma Sports and Orthopedics Institute PLLC. The authorized official on file is Brandon L. Penick, Director Of Reimbursement.
Overview
| NPI | 1063790202 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Oklahoma Sports and Orthopedics Institute PLLC |
| NPI issued | Jul 21, 2011 |
| Last updated in NPPES | Jul 21, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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