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MIRACLE KIDS SUCCESS ACADEMY, INC.
NPI 1639791411
Clinic/Center - Developmental Disabilities in Jonesboro, AR

Active since May 14, 2020
1900 STILLWATER DR, JONESBORO, AR 72404(870) 932-3600 Get Directions Write a Review

NPPES record last updated: November 30, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 30, 2020, May 14, 2020 (2 updates tracked since 2020).

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 1639791411) is a healthcare organization registered as a developmental disabilities in Jonesboro, Arkansas and active in the NPI registry since May 2020. The organization lists Shelly Tucker, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1639791411
Entity TypeOrganization
Primary Taxonomy261QD1600X
Legal Business NameMIRACLE KIDS SUCCESS ACADEMY, INC.
Location Address1900 STILLWATER DRJonesboro, AR 72404-9119
Mailing Address1900 Stillwater DrJonesboro, AR 72404-9119 · (870) 932-3600
Phone(870) 932-3600
Organization SubpartNo
Authorized OfficialShelly TuckerVp Of Operations · (870) 932-3600
Enumeration DateMay 14, 2020
Last NPPES UpdateNovember 30, 20202 updates tracked since enumeration
NPPES CertifiedNovember 30, 2020
✔ NPI 1639791411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities
Taxonomy Code261QD1600X
Definition
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.).
1900 STILLWATER DR, Jonesboro, AR 72404
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Other Identifiers 1

Medicaid239436790AR

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 1639791411. It was assigned to this organization in the NPPES registry on May 14, 2020.

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 Developmental Disabilities, with taxonomy code 261QD1600X.

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.