KIDDOS THERAPY (NPI# 1568959179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568959179 |
| Entity Type | Organization |
| Organization Name | KIDDOS THERAPY |
| Practice Address |
915 W B St Russellville AR 72801-3501 |
| Mailing Address |
1706 W 3rd Pl Russellville AR 72801-4740 |
| Practice Telephone | 4799708351 |
| Practice Fax Number | 4795675582 |
| Mailing Telephone | 4799708351 |
| Mailing Fax Number | 4795675582 |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |
| Authorized Official Name | JODI KUSTURIN (OWNER/DIRECTOR) |
| Authorized Official Telephone | 4799708351 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Street Address |
915 W B ST |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72801-3501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1871134825 | Just Spreading Love Senior Care LLC | Student in an Organized Health Care Education/Training Program | 1411 N. Pittsburg Avenue, Russellville, AR 72801 | 2019-10-01 |
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1407342371 | Andrew James Hickman | Optometrist | 2711 E Parkway Drive, Russellville, AR 72801 | 2018-07-03 |
| 1154859833 | Felicia Head | Speech-Language Pathologist | 220 W 10th St., Russellville, AR 72801 | 2017-05-25 |
| 1295281293 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1605 West Main Street, Russellville, AR 72801 | 2016-08-30 |
| 1467802405 | Kah Development 4, LLC | Hospice Care, Community Based | 3801 W Main St Ste A, Russellville, AR 72801 | 2016-06-21 |
| 1871904839 | Sleep Partners, LLC | Clinic/Center | 1310 West B Street, Suite A, Russellville, AR 72801 | 2014-05-13 |
| 1942647029 | Rpi Sleep Complete LLC | Clinic/Center | 1310 West Main Street, Suite 201, Russellville, AR 72801 | 2013-05-29 |
| 1184967291 | Amedco Arkansas Pllc | Optometrist | 302 N. Phoenix Ave., Clark Eye Clinic, Russellville, AR 72801 | 2013-03-27 |
| Find all providers in zip 72801 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912494527 | Equestrian Zone | Clinic/Center | 4800 S Frankfort Ave, Russellville, AR 72802-0823 | 2018-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029694 | Developmental Milestones Adult Day Center | Clinic/Center | 700 N Missouri St, West Memphis, AR 72301-3150 | 2020-06-29 |
| 1891334835 | Abilities Pediatric Pllc | Clinic/Center | 908 Shorecrest Ave, Harrison, AR 72601-1953 | 2019-12-21 |
| 1174024715 | Lacretia Bruce | Clinic/Center | 12 Fox Run Dr, Little Rock, AR 72210-7133 | 2018-02-27 |
| 1215348552 | Tera Goodman | Clinic/Center | 15 Barber Dr, Hardy, AR 72542-9109 | 2014-05-08 |
| 1790124659 | Kidscorp of Fayetteville, Inc | Clinic/Center | 2210 Main Dr, Springdale, AR 72762-6802 | 2013-06-24 |
| 1710322094 | First Step Arkansas, LLC | Clinic/Center | 6263 Highway 49 South, Paragould, AR 72450 | 2013-05-01 |
| 1043536063 | Cb King Uam Campus | Clinic/Center | 1711 East Ash Street, Mcgehee, AR 71654 | 2010-04-15 |
| 1508037870 | Kids for The Future Rogers, Inc. | Clinic/Center | 3307 N Dixieland Rd, Rogers, AR 72756-6816 | 2008-03-14 |
| 1306979265 | From The Beginning Chms Clinic | Clinic/Center | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2007-03-13 |
| 1851458301 | Boone County Independent Living, Inc. | Clinic/Center | 206 S Cherry St Ste D, Harrison, AR 72601-5044 | 2007-01-03 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 72801 |
Please comment or provide details below to improve the information on KIDDOS THERAPY.
| 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.