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MIRACLE KIDS SUCCESS ACADEMY, INC.
NPI 1568799658
Clinic/Center - Rehabilitation in Jonesboro, AR

Active since November 10, 2009
1900 STILLWATER DR, JONESBORO, AR 72404(870) 932-3600(870) 932-3611 Get Directions Write a Review

NPPES record last updated: November 30, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Nov 30, 2020, Dec 4, 2019 (2 updates tracked since 2019).

About Miracle Kids Success Academy, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRACLE KIDS SUCCESS ACADEMY, INC. (NPI 1568799658) is a healthcare organization registered as a rehabilitation in Jonesboro, Arkansas and active in the NPI registry since November 2009. The organization lists Shelly Keller, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1568799658
Entity TypeOrganization
Primary Taxonomy261QR0400X
Legal Business NameMIRACLE KIDS SUCCESS ACADEMY, INC.
Location Address1900 STILLWATER DRJonesboro, AR 72404-9119
Mailing Address1900 Stillwater DrJonesboro, AR 72404-9119 · (870) 932-3600 · Fax (870) 932-3611
Phone(870) 932-3600
Fax(870) 932-3611
Organization SubpartNo
Authorized OfficialShelly KellerOwner/president · (870) 932-3600
Enumeration DateNovember 10, 2009
Last NPPES UpdateNovember 30, 20202 updates tracked since enumeration
NPPES CertifiedNovember 30, 2020
✔ NPI 1568799658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · RehabilitationAmbulatory Health Care Facilities
Taxonomy Code261QR0400X
Also ListedClinic/Center · Developmental DisabilitiesTaxonomy 261QD1600X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
1900 STILLWATER DR, Jonesboro, AR 72404
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Other Identifiers 1

Medicaid179889724AR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA BROOKE CARMICHAEL
Occupational Therapy Assistant
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
PAULA LONG
Day Training/Habilitation Specialist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
JENNIFER CLARK GARDNER OTR/L
Occupational Therapist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
JAMY COUSINS MS, OTR/L
Occupational Therapist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
MRS. SHANDA DESHA ROGERS P.T.
Physical Therapist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
JACQUELYN BURKE
Day Training/Habilitation Specialist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
MRS. KAITLIN STOBER CCTP, LPC
Counselor (Mental Health)
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600
XEE LEE
Day Training/Habilitation Specialist
1900 STILLWATER DR
JONESBORO, AR 72404
Craighead County (870) 932-3600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miracle Kids Success Academy, Inc.'s NPI number?

The NPI number for Miracle Kids Success Academy, Inc. is 1568799658. It was assigned to this organization in the NPPES registry on November 10, 2009.

Where is Miracle Kids Success Academy, Inc. located?

Miracle Kids Success Academy, Inc. is located at 1900 Stillwater Dr, Jonesboro, AR 72404. The listed phone number is (870) 932-3600.

What is Miracle Kids Success Academy, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

When was this NPI record last updated?

The NPPES record for Miracle Kids Success Academy, Inc. was last updated on November 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.