NPIMap

Organization Active NPI

Kids for the Future of Western Benton County, LLC

Doing business as KidsCorp West

  • Developmental Disabilities Clinic/Center
  • Decatur, AR
National Provider Identifier
1306591201
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
KIDS FOR THE FUTURE OF WESTERN BENTON COUNTY, LLC
Doing business as
KidsCorp West
Practice address
425 S Main St
Decatur, AR 72722-9799
Phone
(479) 212-5030
NPI assigned
Feb 18, 2022
Last updated
Feb 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Shelia Wilkerson
Title
Director
Phone
(479) 986-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

425 S Main St
Decatur, AR 72722-9799

Mailing address

PO Box 130
Rogers, AR 72757-0130

Other names 1

  • KidsCorp West Doing business as

National Provider Directory

National Provider Directory

Locations

425 S Main St
Decatur, AR 72722
Phone (479) 212-5030

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1306591201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727570130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S MAIN ST",
            "city": "DECATUR",
            "state": "AR",
            "postal_code": "727229799",
            "telephone_number": "479-212-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FOR THE FUTURE OF WESTERN BENTON COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "479-986-5150"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidsCorp West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.