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BROADWAY FAMILY PRACTICE
NPI 1578092938
Clinic/Center - Primary Care in Bean Station, TN

Active since June 08, 2017
1179 HIGHWAY 11W, BEAN STATION, TN 37708(865) 993-1070(865) 993-1075 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 8, 2017 (2 updates tracked since 2017).

About Broadway Family Practice NPPES

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

BROADWAY FAMILY PRACTICE (NPI 1578092938) is a healthcare organization registered as a primary care in Bean Station, Tennessee and active in the NPI registry since June 2017. The organization lists Shannon Shultz, Owner, as its authorized official.

NPPES Registry Identity

NPI1578092938
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBROADWAY FAMILY PRACTICE
Location Address1179 HIGHWAY 11WBean Station, TN 37708
Mailing Address1179 Highway 11wBean Station, TN 37708-5809 · (865) 993-1070 · Fax (865) 993-1075
Phone(865) 993-1070
Fax(865) 993-1075
Organization SubpartNo
Authorized OfficialShannon ShultzOwner · (865) 993-1070
Enumeration DateJune 8, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1578092938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1179 HIGHWAY 11W, Bean Station, TN 37708
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Other Providers at the Same Location NPPES 3

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

BEAN STATION FAMILY MEDICINE, PC
Clinic/Center (Primary Care)
1179 HIGHWAY 11W
BEAN STATION, TN 37708
Grainger County (865) 993-1070
SOUTHERN CARE CLINIC LLC
Clinic/Center (Primary Care)
1179 HIGHWAY 11W
BEAN STATION, TN 37708
Grainger County (865) 898-8318
LATASHA M SEAL NP
Nurse Practitioner (Family)
1179 HIGHWAY 11W
BEAN STATION, TN 37708
Grainger County (865) 993-1070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadway Family Practice's NPI number?

The NPI number for Broadway Family Practice is 1578092938. It was assigned to this organization in the NPPES registry on June 8, 2017.

Where is Broadway Family Practice located?

Broadway Family Practice is located at 1179 Highway 11W, Bean Station, TN 37708. The listed phone number is (865) 993-1070.

What is Broadway Family Practice's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Broadway Family Practice was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.