Children'S Express Care Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S EXPRESS CARE CLINIC

Doing business as

Excel Pediatrics

Practice address

10175 Fortune Parkway
Suite 402
Jacksonville, FL 32256

Phone

(904) 519-0008

Fax

(904) 379-7312

NPI assigned

Apr 6, 2018

Organization subpart

Yes

Parent organization

CHILDREN'S EXPRESS CARE CLINICAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suwarna Tilak, MD

Title

President

Phone

(904) 519-0008

Specialties & licenses 1

Addresses

Other names 1

• Excel Pediatrics Doing business as

Tax ID family

Children'S Express Care Clinic4 organizations share this tax ID, including this one

Part of

Children'S Express Care Clinic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Children'S Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • St Johns, FL
  • NPI 1538735246
  NPD tax ID
• Children'S Express Care Clinic

  • Pediatrics Physician
  • Middleburg, FL
  • NPI 1548530736
  NPD tax ID
• Children'S Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Middleburg, FL
  • NPI 1730685157
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Children'S Express Care Clinic

  • Pediatrics Physician
  • Middleburg, FL
  • NPI 1548530736
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1114424280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PARKWAY",
            "address_2": "SUITE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566750",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PARKWAY",
            "address_2": "SUITE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S EXPRESS CARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S EXPRESS CARE CLINIC",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "TILAK",
        "authorized_official_first_name": "SUWARNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-519-0008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Excel Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Child Guidance Center, Inc.
• David Omer Childers Jr., M.D.
• Tommy Kenneth Childers, PHD, LMHC
• Children and Adolescent Behavioral Health Group PLLC
• Children First Pediatrics, PA
• Children'S Health Associates
• Children'S Home Society
• Children'S Home Society of Florida
• Children'S Home Society of Florida
• Children'S Home Society of Florida

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.