Organization Active NPI

Kids Spot LLC

  • Physical Therapy Clinic/Center
  • Springdale, AR
National Provider Identifier
1174845358
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KIDS SPOT LLC
Practice address
724 Deaver St
Springdale, AR 72764-5356
Phone
(479) 259-2339
Fax
(479) 439-8600
NPI assigned
Feb 16, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Hillary Boyd, DPTNPI 1518379015
Title
Owner, Clinical Director
Phone
(479) 259-2339

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

Practitioners 41

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

View all 41

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221024001005 AR DME Supplier - Independently-Practicing Physical Therapist 5991171589 Practice locations: Springdale, AR

National Provider Directory

National Provider Directory

Locations

724 Deaver St
Springdale, AR 72764
Phone (479) 259-2339

105 S Blair St
Springdale, AR 72764
Phone (479) 222-1082

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X SP#1904 AR
Physical Therapy Clinic/Center 261QP2000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

NPPES NPI Registry

Primary practice location

724 Deaver St
Springdale, AR 72764-5356

Mailing address

724 Deaver St
Springdale, AR 72764-5356
Phone (479) 259-2339

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
180643742MedicaidAR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 4, 2024.

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1174845358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 DEAVER ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645356",
            "telephone_number": "479-259-2339",
            "fax_number": "479-439-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 DEAVER ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645356",
            "telephone_number": "479-259-2339",
            "fax_number": "479-439-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS SPOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "479-259-2339",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1904",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180643742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.