NPIMap

Organization Active NPI

Kids Innovative Developmental Services, Inc.

  • Speech-Language Pathologist
  • Fishers, IN
National Provider Identifier
1669931960
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
KIDS INNOVATIVE DEVELOPMENTAL SERVICES, INC.
Practice address
10294 E 96TH St
Fishers, IN 46037-9497
Phone
(317) 288-7572
Fax
(317) 284-1765
NPI assigned
Mar 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Michelle KingNPI 1194892281
Title
President
Phone
(317) 418-2664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

10294 E 96TH St
Fishers, IN 46037-9497

Mailing address

10294 E 96TH St
Fishers, IN 46037-9497
Phone (317) 288-7572

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Fishers

National Provider Directory

National Provider Directory

Locations

10294 E 96th St
#1
Fishers, IN 46037

10294 E 96th St
Fishers, IN 46037
Phone (317) 288-7572

52 S 9th St
Ste 2
Noblesville, IN 46060
Phone (317) 498-7926

52 S 9th St
Ste 3
Noblesville, IN 46060

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1669931960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10294 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379497",
            "telephone_number": "317-288-7572",
            "fax_number": "317-284-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10294 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379497",
            "telephone_number": "317-288-7572",
            "fax_number": "317-284-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS INNOVATIVE DEVELOPMENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-16",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-418-2664"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fishers",
            "affiliation": "N",
            "address_1": "10294 E 96th St # 1",
            "city": "Fishers",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460379497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.