Children's Acceleration Program, Inc

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R125740 Issued in MS

Legal business name

CHILDREN'S ACCELERATION PROGRAM, INC

Practice address

112 Issaquena Ave
Clarksdale, MS 38614-4315

Phone

(662) 627-2741

NPI assigned

Jan 11, 2007

Last updated

Aug 22, 2020By 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

Mrs. Doris Mitchell, NP

Title

Director

Phone

(662) 627-2741

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Children's Acceleration Program Inc2 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.

• Children's Acceleration Program, Inc.

  • Pediatric Nurse Practitioner
  • Cleveland, MS
  • NPI 1912032830
  NPD tax ID

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093865933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1382",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387321382",
            "telephone_number": "662-627-2741",
            "fax_number": "662-846-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ISSAQUENA AVE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144315",
            "telephone_number": "662-627-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S ACCELERATION PROGRAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "662-627-2741",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R125740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00009266",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020541",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Carter, ATC, LAT
• Reba T Carter, MS
• Celestial Comfort Care Hospice
• Mary Haley Chaney, M.E.
• Gwenevere Chew, CFNP
• Childrens Clinic of Clarksdale PA
• Matthew Joe Chow, D.M.D.
• Danielle Clark
• Clarksdale Hma (Northwest Mississippi Regional Medical Center)
• Clarksdale Hma Inc (Clarksdale Phys Svcs EKG)

• Pediatric Nurse Practitioner in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Pediatric Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.