Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BROKEN ARROW PAIN SPECIALIST, LLC
NPI 1104549427
Pain Medicine - Pain Medicine in Tahlequah, OK

Q: What is Broken Arrow Pain Specialist, LLC's NPI number?

The NPI number for Broken Arrow Pain Specialist, LLC is 1104549427. It was assigned to this organization in the NPPES registry on September 21, 2022. The provider is doing business as Oklahoma Pain Specialist.

Q: What is Broken Arrow Pain Specialist, LLC's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Active since September 21, 2022

2028 MAHANEY AVE, TAHLEQUAH, OK 74464(918) 992-6050(833) 763-2349 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 22, 2026, Jul 14, 2026, Sep 21, 2022 (3 updates tracked since 2022).

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About Broken Arrow Pain Specialist, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROKEN ARROW PAIN SPECIALIST, LLC (NPI 1104549427), doing business as Oklahoma Pain Specialist, is a healthcare organization registered as a pain medicine in Tahlequah, Oklahoma and active in the NPI registry since September 2022. The organization lists Ian Kelley, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1104549427

Entity TypeOrganization

Primary Taxonomy208VP0000X

Legal Business NameBROKEN ARROW PAIN SPECIALIST, LLC

Location Address2028 MAHANEY AVETahlequah, OK 74464-5783

Mailing Address2028 Mahaney AveTahlequah, OK 74464-5783 · (918) 992-6050 · Fax (833) 763-2349

Phone(918) 992-6050

Fax(833) 763-2349

Organization SubpartNo

Authorized OfficialIan KelleySole Member · (918) 633-0447

Enumeration DateSeptember 21, 2022

Last NPPES UpdateJuly 22, 20263 updates tracked since enumeration

NPPES CertifiedJuly 22, 2026

✔ NPI 1104549427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0000X

Definition

Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.

2028 MAHANEY AVE, Tahlequah, OK 74464

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Other Names 1

Doing Business AsOklahoma Pain Specialist

Other Identifiers 1

Medicaid200121490AOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAHLEQUAH DRUG COMPANY LLC

Pharmacy (Community/Retail Pharmacy)