Stephanie Santos

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

301 N Sidney Ave
Russellville, AR 72801-4383

Phone

(479) 890-5494

Fax

(479) 498-9665

NPI assigned

Mar 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Ketchum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kid Success, Inc.

  dba The Center of Early Learning

  • Rehabilitation Clinic/Center
  • Conway, AR
  • NPI 1609997311
  NPD (past)

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1356045090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346141",
            "telephone_number": "501-329-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N SIDNEY AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014383",
            "telephone_number": "479-890-5494",
            "fax_number": "479-498-9665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 College Ave",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720346141",
            "country_code": "US",
            "telephone_number": "501-329-5459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KETCHUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ramona Sanders
• Sarah Nash Sanders
• Olivia Paige Sanson, ACSM-CEP, EIM3
• Hilenne Santos Encarnacion
• Jessica Santos-Sanchez
• Jeremy Wayne Saul, MD
• Hanah Marie Savage
• Valina G Schembra
• Joseph Schenck
• Nadjie Schiavo-Kendrick, CASE MANAGER PARA PR

• Behavior Technician in Russellville, AR
• Providers in Russellville, AR by specialty
• Behavior Technician in Arkansas

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