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Children'S Medical Group

Organization Active NPI Family Nurse Practitioner · Milwaukee, WI

NPI 1417299488 · NPPES record last updated Oct 4, 2013

Key facts

NPI
1417299488
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
CHILDREN'S MEDICAL GROUP
Practice address
2320 W Burleigh St
Milwaukee, WI 53206-1751
Phone
(414) 431-9563
Fax
(414) 431-9566
NPI assigned
Mar 18, 2013
Organization subpart
Yes
Parent organization (as reported)
CHILDREN'S MEDICAL GROUP

Authorized official

Name
Dr. Smriti Khare, M.D.
Title
President, Children'S Medical Group
Phone
(414) 266-7615

Corporate family (same tax ID) 37

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

View all 37

National Provider Directory

Tax ID family
Childrens Medical Group Inc (38 organizations share this tax ID)
Part of
Childrens Medical Group Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP		 363LF0000X Yes

Addresses

Primary practice location

2320 W Burleigh St
Milwaukee, WI 53206-1751

Mailing address

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

Other names

  • COA Youth & Family Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 4, 2013.

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1417299488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MAIL STATION 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": "2320 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061751",
            "telephone_number": "414-431-9563",
            "fax_number": "414-431-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL GROUP",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-10-04",
        "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": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COA Youth & Family Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

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Sources for this page

Verify at the official NPI Registry.