Kids Unlimited Learning Academy of Fayetteville

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

KIDS UNLIMITED LEARNING ACADEMY OF FAYETTEVILLE

Practice address

1760 N Woodland Ave
Fayetteville, AR 72703-2549

Phone

(479) 443-4420

NPI assigned

Aug 17, 2023

Last updated

Aug 17, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

MIRACLE KIDS SUCCESS ACADEMY, INC.As reported in NPPES

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

Authorized official

Name

Shelly Keller, MCD, CCC-SLP

Title

Ceo

Phone

(870) 336-8100

Specialties & licenses 1

Addresses

Tax ID family

Kids Unlimited Learning Academy of Fayetteville2 organizations share this tax ID, including this one

Part of

Miracle Kids Success Academy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kids Unlimited Learning Academy of Fayetteville

  • Physical Therapist
  • Fayetteville, AR
  • NPI 1831874114
  NPD tax ID

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1629851191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 SOUTHWEST DR STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048404",
            "telephone_number": "870-336-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 N WOODLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032549",
            "telephone_number": "479-443-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS UNLIMITED LEARNING ACADEMY OF FAYETTEVILLE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIRACLE KIDS SUCCESS ACADEMY, INC.",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-336-8100",
        "authorized_official_credential": "MCD, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Lauren Key, PA-C
• Kristin Dawn Keys, APRN-CNP, WHNP-BC
• Mohammad Arslan Khalid, MD
• Melvin Khanga, MHPP/AT/ YCW
• Brittney Sengchan Khounborine, QBHP
• Kids Unlimited Learning Academy of Fayetteville
• Claire Elizabeth Kifer, P.T.
• Wade Kifer, D.D.S.
• Navin R Kilambi, MD
• Nirmal K Kilambi, M.D.

• Rehabilitation Clinic/Center in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Rehabilitation Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.