NPIMap

Organization Active NPI

Children's Medical Group

Doing business as Greenfield Pediatrics

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1366617581
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S MEDICAL GROUP
Doing business as
Greenfield Pediatrics
Practice address
3365 S 103Rd St Ste 100
Milwaukee, WI 53227-4108
Phone
(414) 321-3951
Fax
(414) 321-8307
NPI assigned
Apr 29, 2008
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Dr. Smriti Khare, MD
Title
President, Children's Medical Group
Phone
(414) 266-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

3365 S 103Rd St Ste 100
Milwaukee, WI 53227-4108

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
32859000MedicaidWI

Other names 1

  • Greenfield Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMG Inc Pediatric CNSL38 organizations share this tax ID, including this one
Part of
CMG Inc Pediatric CNSL

Other organizations with this tax ID 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1366617581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274108",
            "telephone_number": "414-321-3951",
            "fax_number": "414-321-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL GROUP",
        "enumeration_date": "2008-04-29",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "KHARE",
        "authorized_official_first_name": "SMRITI",
        "authorized_official_title_or_position": "PRESIDENT, CHILDREN'S MEDICAL GROUP",
        "authorized_official_telephone_number": "414-266-7615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32859000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenfield Pediatrics",
            "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 Jun 20, 2022; 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.