NPIMap

Organization Active NPI

Childrens Medical Association PA

  • Pediatrics Physician
  • Coral Springs, FL
National Provider Identifier
1164095030
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDRENS MEDICAL ASSOCIATION PA
Practice address
5697 Coral Ridge Dr
Coral Springs, FL 33076-3160
Phone
(954) 580-4800
Fax
(954) 510-4800
NPI assigned
Jul 20, 2021
Organization subpart
Yes
Parent organization
CHILDREN'S MEDICAL ASSOCIATION, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Lakesha Shah
Title
Office Manager
Phone
(954) 722-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

5697 Coral Ridge Dr
Coral Springs, FL 33076-3160

Mailing address

8430 W Broward Blvd Ste 300
Plantation, FL 33324-2700
Phone (954) 473-1011

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1074426Childrens Medical Association5697 Coral Ridge Dr, Coral Springs, FL 33076AccreditationJun 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Childrens Medical Association PA4 organizations share this tax ID, including this one
Part of
Childrens Medical Association PA

Other organizations with this tax ID 3

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

Locations

5697 Coral Ridge Dr
Coral Springs, FL 33076
Phone (954) 473-1101

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1164095030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 W BROWARD BLVD STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242700",
            "telephone_number": "954-473-1011",
            "fax_number": "954-473-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5697 CORAL RIDGE DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763160",
            "telephone_number": "954-580-4800",
            "fax_number": "954-510-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS MEDICAL ASSOCIATION PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL ASSOCIATION, PA",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "LAKESHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-722-0300"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.