CHILDREN'S MEDICAL GROUP (NPI# 1417299488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417299488 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S MEDICAL GROUP |
| Other Organization Name | COA YOUTH & FAMILY CENTER |
| Practice Address |
2320 W Burleigh St Milwaukee WI 53206-1751 |
| Mailing Address |
9000 W Wisconsin Ave Mail Station 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 4144319563 |
| Practice Fax Number | 4144319566 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142666238 |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-10-04 |
| 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 | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| COA Youth & Family Center | 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 |
| 1275708539 | Children's Medical Group | Pediatrics | 24906 75th St, Salem, WI 53168-9705 | 2008-04-28 |
| 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 |
| 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 |
2320 W BURLEIGH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53206-1751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689957755 | Susan Elaine Thaller | Nurse Practitioner | 2320 W Burleigh St, Milwaukee, WI 53206-1751 | 2011-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634332 | Nehemiah House, LLC | Home Health | 3901 N 21st Street, Milwaukee, WI 53206 | 2020-09-22 |
| 1114548542 | Mtc Business Consulting & Management | Case Management | 2640 W Fondulac Ave, Milwaukee, WI 53206 | 2020-04-27 |
| 1558837096 | Allen Matthew Alston | Counselor | 2821 N. 4th St M&s Clinical Svc., Suite 210, Milwaukee, WI 53206 | 2018-10-23 |
| 1891282752 | Valerie Oliver | Midwife | 211 W Capital Dr, Milwaukee, WI 53206 | 2018-04-17 |
| 1629586540 | Major Quality Care, LLC | Assisted Living Facility | 3431 N 13th Street, Milwaukee, WI 53206 | 2018-01-12 |
| 1851812879 | Tony Gardner | Counselor | 3948 N. 18th Street, Milwaukee, WI 53206 | 2017-06-29 |
| 1699103010 | Sweet Butterfly Transportation Service LLC | Non-emergency Medical Transport (VAN) | 3331 North 20 Street, Milwaukee, WI 53206 | 2013-10-22 |
| 1043472558 | Josephine Adams | Registered Nurse | 3541 North 20th Street, Milwaukee, WI 53206 | 2008-06-26 |
| 1023280567 | Roundys Supermarkets Inc | Pharmacy | 9200 N Greenbay Road, Brown Deer, WI 53206 | 2008-03-25 |
| 1285797522 | Gerard D Fontaine | Dentist | 2406 W Capitol Dr, Milwaukee, WI 53206 | 2006-12-18 |
| Find all providers in zip 53206 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203857 | Tiera Manuel | Nurse Practitioner | 3956 N 28th St, Milwaukee, WI 53216-2637 | 2020-10-22 |
| 1801494778 | Tajana Jovicic | Nurse Practitioner | 3157 S 66th St, Milwaukee, WI 53219-4105 | 2020-10-13 |
| 1093320459 | Tyronda T Gray | Nurse Practitioner | 5833 N 117th St, Milwaukee, WI 53225-2207 | 2020-09-12 |
| 1861005837 | Clair Roser Rivera | Nurse Practitioner | 3734 W Ohio Ave, Milwaukee, WI 53215-4047 | 2020-08-28 |
| 1760003909 | Mary Esson | Nurse Practitioner | 100 N 75th St, Milwaukee, WI 53213-3516 | 2020-04-28 |
| 1487297271 | Mackenna Leslie Hill | Nurse Practitioner | 11002 W Park Pl, Milwaukee, WI 53224-3615 | 2019-10-24 |
| 1093276040 | Danielle L Laczniak | Nurse Practitioner | 3070 N 51st St Fl 6, Milwaukee, WI 53210-1645 | 2019-03-30 |
| 1871066506 | Lisa Ann Parker | Nurse Practitioner | 3237 S 16th St # 208, Milwaukee, WI 53215-4526 | 2019-01-04 |
| 1467922948 | Gretchen Louise Grencer-liegel | Nurse Practitioner | 1555 N Rivercenter Dr Ste 205, Milwaukee, WI 53212-3958 | 2018-11-28 |
| 1871074385 | Mary Teresa Falk | Nurse Practitioner | 2350 N Lake Dr Ste 306, Milwaukee, WI 53211-4528 | 2018-08-23 |
| Find all providers in MILWAUKEE | ||||
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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.