NPIMap

Organization Active NPI

Children's Medical Group, Inc., D/B/a Courthouse Pediatrics

  • Pediatrics Physician
  • Gloucester, VA
National Provider Identifier
1215940507
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101026966 Issued in VA
Legal business name
CHILDREN'S MEDICAL GROUP, INC., D/B/A COURTHOUSE PEDIATRICS
Practice address
8264 George Washington Memorial Hwy
Gloucester, VA 23061-4127
Phone
(804) 695-0305
Fax
(804) 695-0804
NPI assigned
Aug 15, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Kathryn J Abshire
Title
Senior VP/Cfo
Phone
(757) 668-8565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101026966 VA Primary

Addresses

Primary practice location

8264 George Washington Memorial Hwy
Gloucester, VA 23061-4127

Mailing address

PO Box 800
Gloucester, VA 23061-0800
Phone (804) 695-0305

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
49D0972344Children's Medical Group, Inc8264 George Washington Memorial Highway, Gloucester, VA 23061Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Children's Medical Group Inc Dba Liberty Pediatrics16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 139

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.

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1215940507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230610800",
            "telephone_number": "804-695-0305",
            "fax_number": "804-695-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8264 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614127",
            "telephone_number": "804-695-0305",
            "fax_number": "804-695-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP, INC., D/B/A COURTHOUSE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "ABSHIRE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "757-668-8565"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101026966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.