NPIMap

Organization Active NPI

Children'S Medical Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
National Provider Identifier
1205068616
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CHILDREN'S MEDICAL GROUP
Practice address
3365 S 103Rd St
Milwaukee, WI 53227-4161
Phone
(414) 228-4800
Fax
(262) 432-9004
NPI assigned
Aug 18, 2009
Organization subpart
Yes
Parent organization
CHILDREN'S MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Dr. Smriti Khare, M.D.
Title
President
Phone
(414) 266-6404

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3365 S 103Rd St
Milwaukee, WI 53227-4161

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other practice location 1

7322 W Rawson Ave
Franklin, WI 53132-8104
Phone (414) 228-4800

Other practice location 2

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone (414) 228-4800

Other practice location 3

2561 N 29th St
Milwaukee, WI 53210-3116
Phone (414) 228-4800

Other practice location 4

4855 S Moorland Rd Ste 150
New Berlin, WI 53151-7495
Phone (414) 228-4800

Other practice location 5

4655 N Port Washington Rd Ste 200
Glendale, WI 53212-1076
Phone (414) 228-4800

Other practice location 6

1655 W Mequon Rd
Mequon, WI 53092-3254
Phone (414) 228-4800

Other identifiers 1

IdentifierTypeStateIssuer
1205068616MedicaidWI

Other names 1

  • MBH Telehealth Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Childrens Medical Group Inc38 organizations share this tax ID, including this one
Part of
Childrens Medical Group Inc

Other organizations with this tax ID 37

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

View all 37

Locations

3365 S 103rd St
Ste 210
Milwaukee, WI 53227
Phone (262) 814-7080

2561 N 29th St
Milwaukee, WI 53210
Phone (414) 264-5338

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1205068616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-228-4800",
            "fax_number": "262-432-9004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7322 W Rawson Ave",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "WI",
            "postal_code": "531328104",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-433-9007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5433 W Fond Du Lac Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532161382",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-277-8939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2561 N 29th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532103116",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-264-5625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4855 S Moorland Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517495",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-425-9803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4655 N Port Washington Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532121076",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-247-1875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 W Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923254",
            "country_code": "US",
            "telephone_number": "414-228-4800",
            "fax_number": "414-247-0894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL GROUP",
        "enumeration_date": "2009-08-18",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "KHARE",
        "authorized_official_first_name": "SMRITI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-266-6404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205068616",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MBH Telehealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.