Broken Arrow Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7205 Issued in OK

Legal business name

BROKEN ARROW NURSING HOME INC

Practice address

424 N Date Ave
Broken Arrow, OK 74012-3872

Phone

(918) 251-5343

Fax

(918) 258-9942

NPI assigned

Mar 22, 2007

Last updated

Mar 11, 2016By 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

Mrs. Joanna Mae Cooper

Title

Owner Operator

Phone

(918) 251-5343

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801913371. Details of each certification follow.

• CCN 375565 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375565

Legal name

BROKEN ARROW NURSING HOME INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 14, 2015

Last certification

Nov 1, 2024

Beds

101

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 18, 1969 in OK

Enrollment address

424 North Date
Broken Arrow, OK 74012-3899

Nursing home name

BROKEN ARROW NURSING HOME, INC

Listed as

Broken Arrow Nursing Home, IncCCN 375565 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Sep 14, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10166.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Howard Brown Jr., MD, DPM

  • Family Medicine Physician
  • Sand Springs, OK
  • NPI 1982699096
  NPD (past)
• Arvid Lade, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1255318168
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1801913371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 N DATE AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123872",
            "telephone_number": "918-251-5343",
            "fax_number": "918-258-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 N DATE AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123872",
            "telephone_number": "918-251-5343",
            "fax_number": "918-258-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "918-251-5343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "7205",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "7205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100772960A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broken Arrow Family Practice Center
• Broken Arrow Family Practice Center PLC
• Broken Arrow Medical Center Inc (Saint Francis Hospital at Broken Arrow)
• Broken Arrow Medical Center Inc (Saint Francis Hospital at Broken Arrow)
• Broken Arrow Medical Center, Inc
• Broken Arrow Pediatric Behavioral Health LLC
• Broken Arrow Pediatrics, LLC
• Broken Arrow Public Schools
• Broken Arrow Rehabilitation Specialists
• Broken Arrow Womens Clinic Inc

• Skilled Nursing Facility in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.