Micah Speaks Kid Camp

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MICAH SPEAKS KID CAMP

Practice address

201 Jeffrey Dr Apt 206G
Lafayette, LA 70503-4566

Phone

(225) 348-6807

NPI assigned

May 3, 2021

Last updated

May 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Ballard

Title

President

Phone

(225) 348-6807

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1407439904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 JEFFREY DR APT 206G",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034566",
            "telephone_number": "225-348-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 JEFFREY DR APT 206G",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034566",
            "telephone_number": "225-348-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICAH SPEAKS KID CAMP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-348-6807"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.micahspeakskidcamp.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "201 Jeffrey Dr Apt 206G",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705034566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Lafayette, LA by specialty
• Multi-Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.