Children'S Clinic LTD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101035213 Issued in VA

Legal business name

CHILDREN'S CLINIC LTD

Practice address

23 Manhattan Square
Hampton, VA 23666

Phone

(757) 595-0358

Fax

(757) 595-6745

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Julian H Blalock Jr Jr., MD

Title

President

Phone

(757) 595-0358

Specialties & licenses 1

Addresses

Other identifiers 14

Locations

Practitioners 12

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

• Amelia Balderston, DO

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1942838636
  NPD (past)
• Julian Blalock Jr., MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1619972833
  NPD (past)
• Margaret V Blanchard, MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1639174436
  NPD (past)
• Elizabeth Broderick, MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1467457697
  NPD (past)
• Richard Raymond Brzeski, MD

  • Pediatrics Physician
  • Newport News, VA
  • NPI 1104821339
  NPD (past)
• Amanda Montgomery Draper, MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1942355441
  NPD (past)
• Erin Lindsey Funderburke, M.D.

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1821447954
  NPD (past)
• Jon Griffiths, MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1972508778
  NPD (past)
• Patricia Lynn Kaufmann, MD

  • Pediatrics Physician
  • Newport News, VA
  • NPI 1699770826
  NPD (past)
• Amber McCusker, MD

  • Pediatrics Physician
  • Hampton, VA
  • NPI 1073780227
  NPD (past)
• Thomas Herbert Koerner, MD

  • Pediatrics Physician
  • Frederick, MD
  • NPI 1316942550
  NPD (past)
• Benjamin R Waddell, DO

  • Pediatrics Physician
  • Bemidji, MN
  • NPI 1811381379
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1306941505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MANHATTAN SQUARE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-595-0358",
            "fax_number": "757-595-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MANHATTAN SQUARE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-595-0358",
            "fax_number": "757-595-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "BLALOCK JR",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-595-0358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101035213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006729932",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006797059",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1467457697",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1639174436",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1699770826",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1972508778",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006716962",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1316942550",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006703828",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010043859",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1104821339",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1619972833",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006769187",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1891790028",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherley Chhibber, MD
• Martha M Chick, MSW, LCSW
• Erica Maria Chigos-White, NP-C
• Naga S Chigurupati, M.D.
• Child of God Group Homesllc
• Childrens Medical Group Inc
• Childrens Physician Group Inc
• Bernard Joseph Chinnapillai
• Debra F Chinnery, EDD, FNP, BC
• Winghan Sammi Chiu, PA

• Pediatrics Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.