The Broadway Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

THE BROADWAY CLINIC

Practice address

1801 N Broadway Ave
Oklahoma City, OK 73103-3446

Phone

(405) 528-1936

Fax

(405) 521-8260

NPI assigned

May 8, 2007

Last updated

Aug 22, 2020By 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

Jerry Burnstein, M.H.A.

Title

Practice Administrator

Phone

(405) 528-1936

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760695274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N BROADWAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731033446",
            "telephone_number": "405-528-1936",
            "fax_number": "405-521-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N BROADWAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731033446",
            "telephone_number": "405-528-1936",
            "fax_number": "405-521-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BROADWAY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNSTEIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "405-528-1936",
        "authorized_official_credential": "M.H.A."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.