CHILDREN'S MEDICAL GROUP (NPI# 1275708539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275708539 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S MEDICAL GROUP |
| Other Organization Name | KENOSHA PEDS - PADDOCK LAKE SITE |
| Practice Address |
24906 75th St Salem WI 53168-9705 |
| Mailing Address |
9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 2628432378 |
| Practice Fax Number | 2628433053 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142661853 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | DR. SMRITI KHARE (PRESIDENT, CHILDREN'S MEDICAL GROUP) |
| Authorized Official Telephone | 4142667615 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32854500 | 05 |
| Other Name | Type Code |
|---|---|
| Kenosha Peds - Paddock Lake Site | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1700222981 | Children's Medical Group | Counselor | 7300 S 13th St, Suite 201, Oak Creek, WI 53154-1832 | 2013-05-15 |
| 1174999163 | Children's Medical Group | Pediatrics | 7861 State Road 60, Cedarburg, WI 53012-9305 | 2015-08-13 |
| 1992171987 | Children's Medical Group | Pediatrics | 611 Veterans Ave Ste 106, West Bend, WI 53090-2545 | 2015-08-13 |
| 1174999262 | Children's Medical Group | Pediatrics | 8800 Washington Ave, Suite 300, Mount Pleasant, WI 53406-3701 | 2015-08-12 |
| 1497154538 | Children's Medical Group | Pediatrics | 7322 W Rawson Ave, Franklin, WI 53132-8104 | 2014-08-14 |
| 1831502327 | Children's Medical Group | Pediatrics | 3365 S 103rd St Ste 210, Milwaukee, WI 53227-4161 | 2014-06-03 |
| 1417299488 | Children's Medical Group | Nurse Practitioner | 2320 W Burleigh St, Milwaukee, WI 53206-1751 | 2013-03-18 |
| 1972845931 | Children's Medical Group | Nurse Practitioner | 1350 W North Ave, Milwaukee, WI 53205-1257 | 2013-03-18 |
| 1932454089 | Children's Medical Group | Pediatrics | 1020 N 12th St, Milwaukee, WI 53233-1308 | 2012-07-16 |
| Street Address |
24906 75TH ST |
| City | SALEM |
| State | WI |
| Zip Code | 53168-9705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752062 | Kimberly Lawrence | Occupational Therapist | 25025 75th St, Salem, WI 53168 | 2020-08-24 |
| 1811557457 | Chadi Farag | Dentist | 25620 75th Street, Salem, WI 53168 | 2019-06-17 |
| 1659708261 | Lisa Marie Looney | Registered Nurse | 5104 294th Ave., Salem, WI 53168 | 2013-09-27 |
| 1720267693 | Central High School District of Westosha | Local Education Agency (LEA) | 24617 75th St, Salem, WI 53168 | 2007-10-29 |
| 1003973108 | Toby Jayne Hawkes | Chiropractor | 24706 75th St., Suite 200, Paddock Lake, WI 53168 | 2007-01-02 |
| 1336171339 | Aurora Pharmacy Inc | Pharmacy | 25320 75th St, Paddock Lake, WI 53168 | 2006-07-07 |
| 1063894723 | Southport Cardiovascular Surgeons LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7137 236th Avenue, #103, Paddock Lake, WI 53168 | 2015-06-18 |
| 1699704296 | Michelle Lynn Baumeister | Occupational Therapy Assistant | 25250 75th St, Paddock Lake, WI 53168 | 2006-07-03 |
| 1710930961 | Paul Norman Schmidt | Physical Therapist | 25250 75th St, Salem, WI 53168-8705 | 2006-05-18 |
| 1073158937 | Kassandra R Kanaga | Occupational Therapist | 25250 75th St, Salem, WI 53168-8705 | 2019-11-14 |
| Find all providers in zip 53168 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730440058 | Matthew Hatler | Pediatrics | 2478 13th St. Se, Salem, OR 97302-2546 | 2012-06-04 |
| 1033409016 | William Christopher Thomsen Jr. | Pediatrics | 1641 Millwood Dr, Salem, VA 24153-4616 | 2011-04-12 |
| 1346378213 | Cooper Pediatrics | Pediatrics | 330 Woodstown Road., Medical Arts Bldg 7, Salem, NJ 08079 | 2007-03-01 |
| 1053424291 | Linda J Morgan | Pediatrics | 57 Highlands Ave, Er, Salem, MA 01970 | 2006-08-15 |
| 1700813854 | Dorin Meredith Kemmerle | Pediatrics | 4350 Commercial St Se, Salem, OR 97302-3914 | 2006-06-26 |
| 1043252612 | Kimberly Ann Heggen | Pediatrics | 891 23rd St Ne, Salem, OR 97301-1793 | 2006-06-11 |
| 1770525263 | Fara Katrina Etzel | Pediatrics | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-11 |
| 1083675953 | Donald T Mcauliffe | Pediatrics | 72 Highland Avenue, Pediatric Associates of Greater Salem, Salem, MA 01970 | 2006-03-30 |
| 1336116474 | Madeleine Ana Ortiz | Pediatrics | 1076 E State St, Salem, OH 44460-2228 | 2006-03-08 |
| 1104813062 | Edward Zalitis | Pediatrics | 72 Highland Ave, Salem, MA 01970-2738 | 2005-10-05 |
| Find all providers in SALEM | ||||
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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.