MIRACLE KIDS SUCCESS ACADEMY OF TRUMANN (NPI# 1063979243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063979243 |
| Entity Type | Organization |
| Organization Name | MIRACLE KIDS SUCCESS ACADEMY OF TRUMANN |
| Practice Address |
1005 Balcom Ln Trumann AR 72472-9502 |
| Mailing Address |
1900 Stillwater Dr Jonesboro AR 72404-9119 |
| Practice Telephone | 8707616680 |
| Mailing Telephone | 8709323600 |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |
| Authorized Official Name | SHELLY KELLER (CEO) |
| Authorized Official Telephone | 8707616680 |
| Authorized Official Credential | MCD, CCC-SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326505504 | Miracle Kids Success Academy of Trumann | Clinic/Center | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-02-25 |
| Street Address |
1005 BALCOM LN |
| City | TRUMANN |
| State | AR |
| Zip Code | 72472-9502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770658338 | Jennifer Ross | Speech-Language Pathologist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2006-11-21 |
| 1013531391 | James Bradford Bates | Registered Nurse | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2020-06-03 |
| 1982240990 | Ginnie Burton | Registered Nurse | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-11-25 |
| 1093350712 | Mallory Grimes | Occupational Therapist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-11-18 |
| 1194366625 | Jennifer Elizabeth Lorince | Speech-Language Pathologist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-10-07 |
| 1811547268 | Tiffany Martin | Day Training/Habilitation Specialist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-09-18 |
| 1942859293 | Autumn Mars | Day Training/Habilitation Specialist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-09-10 |
| 1225683113 | Elizabeth Reed | Day Training/Habilitation Specialist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-08-07 |
| 1124687892 | Elizabeth Hampton | Day Training/Habilitation Specialist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-06-06 |
| 1457917460 | Cheryl Mcclard | Registered Nurse | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2019-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063039980 | First Step Arkansas, LLC | Occupational Therapist | 528 Industrial Park Access Rd, Trumann, AR 72472 | 2020-06-26 |
| 1982254710 | Brent A Davis | Physical Therapist | 516 Industrial Park Access Rd, Trumann, AR 72472 | 2019-09-13 |
| 1760992911 | Lorraine Irene Devries | Technician | 1316 Industrial Acess Drive, Trumann, AR 72472 | 2017-10-02 |
| 1902326226 | Logan Michael Schmidt | Dentist | 1711 Hwy 69 Blvd, Trumann, AR 72472 | 2017-06-27 |
| 1619228830 | Daniel Edward Ward | Case Manager/Care Coordinator | 1704 Hwy, 69, Trumann, AR 72472 | 2012-09-27 |
| 1003197542 | Mashae D. Rolland | Nurse Practitioner | 808 Highway 463 N, Trumann, AR 72472 | 2011-08-29 |
| 1982984118 | Denise Jackson | Case Manager/Care Coordinator | 1704 Highway 69, Trumann, AR 72472 | 2011-08-19 |
| 1134410467 | Dalisha Lareece Smith | Clinical Ethicist | 1704 Hwy. 69, Trumann, AR 72472 | 2011-04-20 |
| 1164727202 | Margaret Ann Peters | Case Manager/Care Coordinator | 809 West Main Suite C, Trumann, AR 72472 | 2011-01-21 |
| 1134379357 | Jeremiah Daniel Dillehay | Counselor | 170 4 Hwy. 69, Trumann, AR 72472 | 2008-09-24 |
| Find all providers in zip 72472 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982254710 | Brent A Davis | Physical Therapist | 516 Industrial Park Access Rd, Trumann, AR 72472 | 2019-09-13 |
| 1104972264 | Trinity D Courtney | Physical Therapist | 1005 Balcom Lane, Ascent Children's Health Services, Trumann, AR 72472 | 2007-01-25 |
| 1386700185 | David Michael Felts | Physical Therapist | 1300 Industrial Dr, Trumann, AR 72472 | 2006-12-28 |
| 1730734476 | Kidspot Trumann Inc. | Physical Therapist | 339 Highway 463 N, Trumann, AR 72472-3505 | 2019-08-08 |
| 1124685318 | Kidsplace Learning Center Dba Kidspot | Physical Therapist | 339 Highway 463 N, Trumann, AR 72472-3505 | 2019-05-22 |
| 1477037604 | Brandon K Garner | Physical Therapist | 516 Industrial Park Dr, Trumann, AR 72472-9602 | 2018-09-24 |
| 1366798704 | Michael Wayne Traylor | Physical Therapist | 305 W Main St, Trumann, AR 72472-3114 | 2012-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462310 | Stephanie Joy Bird | Physical Therapist | 24711 Ar-5, Lonsdale, AR 72087 | 2020-09-17 |
| 1477166361 | Superior Pediatrics, Pllc | Physical Therapist | 100 Dawson St, Marked Tree, AR 72365-2221 | 2020-08-28 |
| 1407469604 | Garrett Branaman | Physical Therapist | 759 Highway 62 E Ste 331, Mountain Home, AR 72653-3263 | 2020-08-26 |
| 1972116481 | Kendra Kay Romig | Physical Therapist | 1617 Brookwood Dr, Little Rock, AR 72202 | 2020-08-25 |
| 1265045710 | Kathryn Magness | Physical Therapist | 5507 W Walsh Ln Ste 102, Rogers, AR 72758-8951 | 2020-08-25 |
| 1487266367 | Brooke Elizabeth Kiene | Physical Therapist | 2210 N Main St, Greenwood, AR 72936-7709 | 2020-08-20 |
| 1497367767 | Alma Physical Therapy, LLC | Physical Therapist | 108 Highway 71 N Ste 114, Alma, AR 72921-5046 | 2020-08-18 |
| 1295352946 | Jantsen Hunter Lynn | Physical Therapist | 2070 Mckenzie Rd Ste A, Springdale, AR 72762-0870 | 2020-06-29 |
| 1295352136 | Jessica Czarnecki | Physical Therapist | 2668 E Citizens Dr Ste 4, Fayetteville, AR 72703-4796 | 2020-06-26 |
| 1205453255 | Courtney Bogan | Physical Therapist | 9820 Dollard Rd, Mountainburg, AR 72946-3350 | 2020-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.