Broadway Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BROADWAY FAMILY PRACTICE

Practice address

1179 Highway 11W
Bean Station, TN 37708

Phone

(865) 993-1070

Fax

(865) 993-1075

NPI assigned

Jun 8, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Shannon Shultz

Title

Owner

Phone

(865) 993-1070

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1578092938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 HIGHWAY 11W",
            "city": "BEAN STATION",
            "state": "TN",
            "postal_code": "377085809",
            "telephone_number": "865-993-1070",
            "fax_number": "865-993-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 HIGHWAY 11W",
            "city": "BEAN STATION",
            "state": "TN",
            "postal_code": "37708",
            "telephone_number": "865-993-1070",
            "fax_number": "865-993-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHULTZ",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-993-1070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Lee Barnett, PHARM.D.
• Bean Station Family Medicine, PC
• William Brashears
• Joey Cole
• Jimmy E Collins Jr., DPH
• Stacie Nicole Davy, FNP-C
• DHP Medical Services LLC
• Down Home Pharmacy

• Primary Care Clinic/Center in Bean Station, TN
• Providers in Bean Station, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.