Organization Active NPI

Broken Arrow Public Schools

  • Psychologist
  • Broken Arrow, OK
National Provider Identifier
1669580502
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BROKEN ARROW PUBLIC SCHOOLS
Practice address
112 N Main St
Broken Arrow, OK 74012-3937
Phone
(918) 259-4540
Fax
(918) 258-0958
NPI assigned
Aug 29, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jamie Gilroy
Title
Medicaid Coordinator
Phone
(918) 259-4540

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

112 N Main St
Broken Arrow, OK 74012-3937

Mailing address

112 N Main St
Broken Arrow, OK 74012-3937
Phone (918) 259-4540

National Provider Directory

National Provider Directory

Locations

112 N Main St
Broken Arrow, OK 74012
Phone (918) 259-4540

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669580502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N MAIN ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123937",
            "telephone_number": "918-259-4540",
            "fax_number": "918-258-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N MAIN ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123937",
            "telephone_number": "918-259-4540",
            "fax_number": "918-258-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW PUBLIC SCHOOLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GILROY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "MEDICAID COORDINATOR",
        "authorized_official_telephone_number": "918-259-4540"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.