MKJD, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

MKJD, LLC

Doing business as

STARS Academy South

Practice address

2040 Fitzhugh St
Batesville, AR 72501-7409

Phone

(870) 793-3500

Fax

(870) 793-3501

NPI assigned

Jan 11, 2019

Last updated

Jan 11, 2019By 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

Wendy Barnt

Title

Billing Manager

Phone

(870) 793-3200

Specialties & licenses 4

Addresses

Other names 1

• STARS Academy South Doing business as

Tax ID family

MKJD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• MKJD, LLC

  dba STARS Academy

  • Rehabilitation Clinic/Center
  • Batesville, AR
  • NPI 1336587559
  NPD tax ID

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1063986123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 FITZHUGH ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017409",
            "telephone_number": "870-793-3500",
            "fax_number": "870-793-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 FITZHUGH ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017409",
            "telephone_number": "870-793-3500",
            "fax_number": "870-793-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKJD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "BARNT",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "870-793-3200"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STARS Academy South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miracle Kids Success Academy
• Miracle Kids Success Academy, Inc.
• Angela Mitchell
• Jenny Lee Mitchell, MSN, APRN, FNP-BC
• Pamela Michelle Mize, APRN
• MKJD, LLC (STARS Academy)
• Ashley Montgomery
• Lackey Gene Moody, M.D.
• Melody Lynne Moody, MD
• Jennifer Moon, LCSW

• Rehabilitation Clinic/Center in Batesville, AR
• Providers in Batesville, AR by specialty
• Rehabilitation Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.