Kids Unlimited Learning Academy of Fayetteville

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KIDS UNLIMITED LEARNING ACADEMY OF FAYETTEVILLE

Practice address

1760 N Woodland Ave
Fayetteville, AR 72703-2549

Phone

(870) 336-8100

NPI assigned

Jun 15, 2023

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 3

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

  • Rehabilitation Clinic/Center
  • Fayetteville, AR
  • NPI 1629851191
  NPD tax ID

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1831874114",
    "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": "870-336-8100"
        }
    ],
    "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": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "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": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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.
• John Kilcrease

• Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.