NPIMap

Organization Active NPI

Miracle Kids Success Academy Central

  • Developmental Disabilities Clinic/Center
  • Jonesboro, AR
National Provider Identifier
1326844267
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MIRACLE KIDS SUCCESS ACADEMY CENTRAL
Practice address
1607 Stone St
Jonesboro, AR 72401-5332
Phone
(870) 336-4100
NPI assigned
Feb 21, 2025
Last updated
Feb 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MIRACLE KIDS SUCCESS ACADEMY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Jeremy Edward Ellis, CPA
Title
Controller
Phone
(870) 336-8100

Specialties & licenses 1

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

Addresses

Primary practice location

1607 Stone St
Jonesboro, AR 72401-5332

Mailing address

3127 Southwest Dr
Jonesboro, AR 72404-8404
Phone (870) 336-8100

National Provider Directory

National Provider Directory
Tax ID family
Miracle Kids Success Academy Central4 organizations share this tax ID, including this one
Part of
Miracle Kids Success Academy

Other organizations with this tax ID 3

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

Locations

3127 Southwest Dr
Jonesboro, AR 72404

Practitioners & affiliated clinicians

Practitioners 74

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 74

NPI Registry JSON

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1326844267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048404",
            "telephone_number": "870-336-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 STONE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015332",
            "telephone_number": "870-336-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE KIDS SUCCESS ACADEMY CENTRAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIRACLE KIDS SUCCESS ACADEMY, INC.",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "870-336-8100",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.