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30:17 RECOVERY
NPI 1679331284
Internal Medicine - Addiction Medicine in Jackson, TN

Active since March 08, 2024
188 CARRIAGE HOUSE DR, JACKSON, TN 38305(731) 215-0049(800) 418-1395 Get Directions Write a Review

NPPES record last updated: March 8, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 30:17 Recovery NPPES

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

30:17 RECOVERY (NPI 1679331284) is a healthcare organization registered as an addiction medicine in Jackson, Tennessee and active in the NPI registry since March 2024. The organization lists Melissa Mcbroom, Director, as its authorized official.

NPPES Registry Identity

NPI1679331284
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business Name30:17 RECOVERY
Location Address188 CARRIAGE HOUSE DRJackson, TN 38305-3969
Mailing Address188 Carriage House DrJackson, TN 38305-3969 · (731) 215-0049 · Fax (800) 418-1395
Phone(731) 215-0049
Fax(800) 418-1395
Organization SubpartNo
Authorized OfficialMelissa McbroomDirector · (731) 215-0449
Enumeration DateMarch 8, 2024
✔ NPI 1679331284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
188 CARRIAGE HOUSE DR, Jackson, TN 38305
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 30:17 Recovery's NPI number?

The NPI number for 30:17 Recovery is 1679331284. It was assigned to this organization in the NPPES registry on March 8, 2024.

Where is 30:17 Recovery located?

30:17 Recovery is located at 188 Carriage House Dr, Jackson, TN 38305. The listed phone number is (731) 215-0049.

What is 30:17 Recovery's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

When was this NPI record last updated?

The NPPES record for 30:17 Recovery was last updated on March 8, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.