CHILDREN'S MEDICAL GROUP (NPI# 1710152954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710152954 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S MEDICAL GROUP |
| Practice Address |
4655 N Port Washington Rd Ste 200 Glendale WI 53212-1076 |
| Mailing Address |
9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 4142479530 |
| Practice Fax Number | 4142471875 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142661853 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2017-11-10 |
| Authorized Official Name | DR. SMRITI KHARE (PRESIDENT, CHILDREN'S MEDICAL GROUP) |
| Authorized Official Telephone | 4142667615 |
| Authorized Official Credential | MD |
| 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 | 1710152954 | 05 |
| 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 |
| 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 |
| Street Address |
4655 N PORT WASHINGTON RD STE 200 |
| City | GLENDALE |
| State | WI |
| Zip Code | 53212-1076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881691418 | Promise Dzakpasu | Pediatrics | 4655 N Port Washington Rd Ste 200, Glendale, WI 53212-1076 | 2005-06-28 |
| 1770520983 | Cheryl M. Cameron | Pediatrics | 4655 N Port Washington Rd Ste 200, Glendale, WI 53212 | 2006-05-31 |
| 1528053865 | Kimberlie A Ward | Pediatrics | 4655 N Port Washington Rd Ste 200, Glendale, WI 53212-1076 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| 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 |
|---|---|---|---|---|
| 1619485489 | Pleasant Pediatrics Plc | Pediatrics | 9980 W Glendale Ave Ste 130, Glendale, AZ 85307-3007 | 2018-01-16 |
| 1518412311 | Saul Grullon | Pediatrics | 7848 73rd Pl, Glendale, NY 11385-7426 | 2016-08-22 |
| 1376921106 | Pleasant Pediatrics Plc | Pediatrics | 5125 W Myrtle Ave, Glendale, AZ 85301-2007 | 2015-05-13 |
| 1770987158 | Alice Abrahamian Md, A Medical Corporation | Pediatrics | 411 N Central Ave Ste 130, Glendale, CA 91203-2092 | 2014-10-14 |
| 1144634510 | Josephine Moukhtar | Pediatrics | 1816 Orchard Ave Apt 1, Glendale, CA 91206-4179 | 2014-06-13 |
| 1386068419 | Jean Bove Goerss | Pediatrics | 7101 W Beardsley Rd, Unit 741, Glendale, AZ 85308-5699 | 2014-02-10 |
| 1811230139 | Caroline Kim Park | Pediatrics | 801 S Chevy Chase Dr Ste 200, Glendale, CA 91205-4435 | 2013-04-04 |
| 1396049235 | Parvaneh Rafaeloff, Md, Inc. | Pediatrics | 1030 S. Glendale Ave #308, Glendale, CA 91205-2866 | 2011-01-07 |
| 1649572652 | Gagik Khoylyan, M.d., Inc. | Pediatrics | 540 N Central Ave Ste 105, Glendale, CA 91203-3350 | 2010-11-23 |
| 1497985386 | Melissa C Jones | Pediatrics | 3575 W Deer Valley Rd, Suite 100, Glendale, AZ 85308 | 2009-07-25 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on CHILDREN'S MEDICAL GROUP.
| 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.