NPIMap

Organization Active NPI

Kidz Kan, LLC

  • Occupational Therapist
  • Beebe, AR
National Provider Identifier
1013139401
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
KIDZ KAN, LLC
Practice address
27 Highway 64 West
Beebe, AR 72012-2094
Phone
(501) 230-3100
Fax
(501) 882-9825
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kelley D Lewis, OTRLNPI 1184673493
Title
Administrator
Phone
(501) 230-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

27 Highway 64 West
Beebe, AR 72012-2094

Mailing address

130 Underhill Rd
Beebe, AR 72012-9751
Phone (501) 230-3100

Other identifiers 1

IdentifierTypeStateIssuer
156889742MedicaidAR

National Provider Directory

National Provider Directory

Locations

27 Highway 64 W
Beebe, AR 72012
Phone (501) 230-3707

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1013139401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 UNDERHILL RD",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720129751",
            "telephone_number": "501-230-3100",
            "fax_number": "501-882-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 HIGHWAY 64 WEST",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720122094",
            "telephone_number": "501-230-3100",
            "fax_number": "501-882-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ KAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-230-3100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156889742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beebe, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.