The Kid Zone Camp, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE KID ZONE CAMP, LLC

Practice address

401 Central Ave
Butner, NC 27509

Phone

(919) 768-3383

NPI assigned

Aug 25, 2023

Last updated

Mar 31, 2026By 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

Robin W Midyette

Title

Member

Phone

(919) 768-3383

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1538944905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 ROGERS POINTE LN",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275228255",
            "telephone_number": "919-768-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CENTRAL AVE",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "27509",
            "telephone_number": "919-768-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KID ZONE CAMP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "MIDYETTE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "919-768-3383"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prathima Surapaneni, MD
• Londyn Swann, PSY.D.
• Elizabeth Taber, PHARMD
• Jeffrey Lewis Teal, RPH
• Tracy Dail Teal, PHARMD
• Donald Allen Thompson III, PHARMD
• Julie Ellen Reinecke Toporek, M.S., OTR/L
• Christine Danielle Tronnier, MSW
• Jordan Tryhubenko, PHARMD
• Karen Ann Tucker, PH.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Butner, NC
• Providers in Butner, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.