NPIMap

Organization Active NPI

Kids for the Future of Marianna, Inc.

  • Early Intervention Provider Agency
  • Marianna, AR
National Provider Identifier
1285954339
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
14012 Issued in AR
Legal business name
KIDS FOR THE FUTURE OF MARIANNA, INC.
Practice address
401 W Main St
Marianna, AR 72360-2102
Phone
(870) 295-5280
Fax
(870) 295-5390
NPI assigned
Jun 10, 2010
Last updated
Jun 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name
Dr. Thomas R Heisler, PHD
Title
Ceo
Phone
(870) 295-5280

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 14012 AR
Speech-Language Pathologist 235Z00000X 14012 AR
Early Intervention Provider Agency 252Y00000X 14012 AR Primary

Addresses

Primary practice location

401 W Main St
Marianna, AR 72360-2102

Mailing address

401 W Main St
PO Box 1102
Marianna, AR 72360-2102
Phone (870) 295-5280

Other identifiers 1

IdentifierTypeStateIssuer
181131724MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Kids for the Future of Marianna 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.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1285954339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "address_2": "PO BOX 1102",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "723602102",
            "telephone_number": "870-295-5280",
            "fax_number": "870-295-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "723602102",
            "telephone_number": "870-295-5280",
            "fax_number": "870-295-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FOR THE FUTURE OF MARIANNA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "HEISLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-295-5280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "14012",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "14012",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "AR",
            "license": "14012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181131724",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.