Kid Champion Holding LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KID CHAMPION HOLDING LLC

Practice address

11400 N Rodney Parham Rd Ste C
Little Rock, AR 72212-4124

Phone

(501) 954-0667

NPI assigned

Apr 12, 2023

Organization subpart

No

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

Authorized official

Name

Kevin Lee Kelley

Title

Manager / Ceo

Phone

(501) 804-9298

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1487340535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 N RODNEY PARHAM RD STE C",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124124",
            "telephone_number": "501-804-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 N RODNEY PARHAM RD STE C",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124124",
            "telephone_number": "501-954-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID CHAMPION HOLDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER / CEO",
        "authorized_official_telephone_number": "501-804-9298"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamir Khan, MD
• Khaled Riad Khasawneh, MD
• Sarah Khot
• Mohammad Zaher Khrais, MD
• Paige Kibbey, DPT
• Kidd Kave Learning Center
• Anna Melissa Kidd, APRN-CNP
• Sheryl Kidd, QBHP
• Kidney Care Center, PLLC
• Kids Therapy

• Community/Behavioral Health Agency in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Community/Behavioral Health Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.