Child & Adolescent Clinic, PS

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILD & ADOLESCENT CLINIC, PS

Practice address

971 11TH Ave
Longview, WA 98632

Phone

(360) 577-1771

Fax

(360) 423-1405

NPI assigned

May 23, 2006

Last updated

Jul 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Phyllis Cavens, M.D.

Title

Physician/Owner

Phone

(360) 577-1771

Specialties & licenses 1

Addresses

Other identifiers 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Child and Adolescent Clinic

  dba Child and Adolescent Clinic Health Homes

  • Case Manager/Care Coordinator
  • Longview, WA
  • NPI 1134657778
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Annette Pearl Ville, MD

  • Pediatrics Physician
  • Longview, WA
  • NPI 1093276123
  NPD (past)
• Kenneth R Wu, M.D.

  • Pediatrics Physician
  • Longview, WA
  • NPI 1336105055
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1144275777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322503",
            "telephone_number": "360-577-1771",
            "fax_number": "360-423-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-577-1771",
            "fax_number": "360-423-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & ADOLESCENT CLINIC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "CAVENS",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "360-577-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7066202",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad C Chesley, M.D.
• Susan Lynn Chesley, CRNA
• Ian Matthew Cheslock
• John N Cheslock, OD
• William V Cheslock, OD
• Child and Adolescent Clinic (Child and Adolescent Clinic Health Homes)
• Alyssa Nicole Childers
• Athenia Childers, BS, MSCJO, QMPH - R
• Brandi Marie Childers, LMP
• Anthony Ryan Chilton, DC

• Pediatrics Physician in Longview, WA
• Providers in Longview, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.