CHILDREN'S ACCELERATION PROGRAM, INC


Address: 112 Issaquena Ave, Clarksdale, MS 38614-4315
Phone: 6626272741

CHILDREN'S ACCELERATION PROGRAM, INC (NPI# 1093865933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093865933
Entity Type Organization
Organization Name CHILDREN'S ACCELERATION PROGRAM, INC
Practice Address 112 Issaquena Ave
Clarksdale
MS 38614-4315
Mailing Address Po Box 1382
Cleveland
MS 38732-1382
Practice Telephone 6626272741
Mailing Telephone 6626272741
Mailing Fax Number 6628466306
Enumeration Date 2007-01-11
Last Update Date 2020-08-22
Authorized Official Name MRS. DORIS MITCHELL (DIRECTOR)
Authorized Official Telephone 6626272741
Authorized Official Credential NP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
R125740 MS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MS 00009266 05
MS 00020541 05

Office Location

Street Address 112 ISSAQUENA AVE
City CLARKSDALE
State MS
Zip Code 38614-4315

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295115269 Compassionate Hands Inc In Home Supportive Care 112 Issaquena Ave, Clarksdale, MS 38614-4315 2015-06-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386265627 Lillie Mae Lockett Technician 1025 Ritchie Ave, Clarksdale, MS 38614 2020-04-28
1063957751 Autospa-healthy Youth Center Nurse Practitioner 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 2017-01-04
1700226123 Nikki Nikkia Cager Internal Medicine 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 2013-06-29
1205186947 Celestial Comfort Care Hospice Hospice Care, Community Based 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 2012-09-10
1063667129 The Smile Center of Clarksdale Clinic/Center 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 2008-11-17
1801060033 Clarksdale Municipal School District Local Education Agency (LEA) Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 2008-04-18
1184806150 Mary A Williams Nurse Practitioner 125 Highway 322, Clarksdale, MS 38614 2007-12-03
1114040367 William F Wilson Jr. Dentist 850 Desoto Ave, Extended, Clarksdale, MS 38614 2007-04-10
1952434920 Kathleen Tinnel Nurse Practitioner 2245 N State St, Clarksdale, MS 38614 2007-03-13
1497888457 Carole L Mangrem Pediatrics 2245 N Starte St, Clarksdale, MS 38614 2007-03-13
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952434920 Kathleen Tinnel Nurse Practitioner 2245 N State St, Clarksdale, MS 38614 2007-03-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376142943 Ashley B Chittenden Nurse Practitioner 3480 Avis Ln, Southaven, MS 38672-2010 2020-10-23
1437760881 Elizabeth Smith Nurse Practitioner 3631 Bienville Blvd Ste A, Ocean Springs, MS 39564-5702 2020-08-10
1750879003 Heather Lynn Theisen Nurse Practitioner 15190 Community Rd Ste 330, Gulfport, MS 39503 2018-04-23
1972021608 Dana Brooke Underwood Nurse Practitioner 1300 Access Rd Ste 400, Oxford, MS 38655-5211 2017-09-01
1891233276 Optimum Healthcare Associates, Pa Nurse Practitioner 5350 Executive Pl, Suite 8, Jackson, MS 39206-4100 2017-02-06
1386020113 Stefanie Taylor Christy Nurse Practitioner 3654b New Hope Rd, Columbus, MS 39702-8521 2015-08-04
1861808974 Ashley Hickman Nurse Practitioner 224 S Church St Ste B, Brookhaven, MS 39601-3232 2014-07-09
1528486289 Thomas Stallworth Nurse Practitioner 4105 Hospital St Ste 104, Pascagoula, MS 39581 2014-03-31
1962744482 Kendra Watts Nurse Practitioner 1016 Sixth Ave Ste C, Picayune, MS 39466-3861 2013-03-22
1730340563 Kayti A Powell Nurse Practitioner 1488 Hwy 487 East, Sebastopol, MS 39359-0150 2008-06-24
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Competitor

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City CLARKSDALE
Zip Code 38614

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Dataset Information

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.

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