Individual provider Active NPI

Amanda Baker McKeigney-Childs, LCSW

  • Clinical Social Worker
  • Rogers, AR
National Provider Identifier
1407976632
Registry record updated Jun 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6599-C Issued in AR
Practice address
204 S 24TH St
Rogers, AR 72758
Phone
(479) 621-0301
NPI assigned
Mar 30, 2007
Last updated
Jun 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X PLMSW AR
Clinical Social Worker 1041C0700X 6599-C AR Primary
Case Manager/Care Coordinator 171M00000X AR
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

204 S 24TH St
Rogers, AR 72758

Mailing address

401 N 8TH St # 997
Rogers, AR 72756-3761
Phone (479) 274-8271

Other practice location 1

2003 SE Walton Blvd
Bentonville, AR 72712-3725
Phone (479) 464-8081

Other practice location 2

1803 SW Regional Airport Blvd Ste 5
Bentonville, AR 72712-8792
Phone (479) 876-8626

Other names 1

  • Amanda Childs Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6599-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
PT Concepts, PLLC PastSince Dec 1, 2017 Accepting new patients
John L. Shasteen LLC Clinical Past Accepting new patients
Shared Families of Northwest Arkansas L.L.C. Clinical PastSince May 24, 2020 Accepting new patients
Conway County Community Service Inc. Past Accepting new patients
Ask Wellness Center,LLC Clinical Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529798400000",
    "number": "1407976632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 8TH ST # 997",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563761",
            "telephone_number": "479-274-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S 24TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-621-0301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 SE Walton Blvd",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727123725",
            "country_code": "US",
            "telephone_number": "479-464-8081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1803 SW Regional Airport Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727128792",
            "country_code": "US",
            "telephone_number": "479-876-8626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEIGNEY-CHILDS",
        "first_name": "AMANDA",
        "middle_name": "BAKER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2018-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "PLMSW",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6599-C",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CHILDS",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2018; 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.