Kids Are Special LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KIDS ARE SPECIAL LLC

Practice address

880 Colloredo Blvd
Shelbyville, TN 37160-2774

Phone

(931) 685-8111

NPI assigned

Oct 13, 2022

Last updated

Oct 13, 2022By 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

Sydni Clemmons

Title

Credentialing Manager

Phone

(931) 253-1110

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1427774256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 CAROTHERS PKWY STE 225",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676662",
            "telephone_number": "931-253-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602774",
            "telephone_number": "931-685-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS ARE SPECIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "CLEMMONS",
        "authorized_official_first_name": "SYDNI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "931-253-1110"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007192",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara F Kaczmarska, M.D.
• Patti J. Kamykowski, N.P.
• Laura Rose Keith, OD
• Charles E Kelly II, MD
• Cory Lyn Kenyon, D.C.
• Kerry Kiesiner, D.C.
• Tressanique Kihugu, LPC-MHSP
• Marvin Clay Koonce, DDS
• Kroger Limited Partnership I (Kroger Pharmacy)
• Janet R. Lamb, LPC-MHSP

• Family Medicine Physician in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.