Broken Arrow
Broken Arrow is a healthcare organization registered as Addiction Medicine (Family Medicine) Physician in Jefferson City, TN, holding Type 2 (organization) NPI 1720841042 since 2024. The authorized official on file is Crissy Shank, Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1720841042 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Broken Arrow |
| Practice address | 1009 E HIGHWAY 11 E, Jefferson City, TN, 37760 |
| Phone | 8659350411 |
| Enumeration date | 2024-01-31 |
| Last updated in NPPES | 2024-01-31 |
Authorized official
| Name | Crissy Shank |
|---|---|
| Title | Manager |
| Phone | 9317615732 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | Primary | — | — |
Copy-ready billing details
Provider: Broken Arrow NPI: 1720841042 Taxonomy: 207QA0401X (Addiction Medicine (Family Medicine) Physician) Address: 1009 E HIGHWAY 11 E, Jefferson City, TN, 37760
Verify this record
Cross-check NPI 1720841042 against the authoritative CMS record: view Broken Arrow on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Broken Arrow?
Who is the authorized official for Broken Arrow?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-01-31.