NPIMap

Organization Active NPI

Childrens Community Care

Doing business as Childrens Community Pediatrics

  • Pediatrics Physician
  • Greenville, PA
National Provider Identifier
1558546366
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDRENS COMMUNITY CARE
Doing business as
Childrens Community Pediatrics
Practice address
90 Shenango St Ste 12
Greenville, PA 16125-2060
Phone
(724) 589-0290
Fax
(724) 589-0293
NPI assigned
Dec 31, 2007
Last updated
Sep 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Authorized official

Name
Lori Martinez
Title
Executive Administrator III
Phone
(724) 933-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

90 Shenango St Ste 12
Greenville, PA 16125-2060

Mailing address

103 Bradford Rd Ste 200
Wexford, PA 15090-6910
Phone (724) 933-1100

Other names 1

  • Childrens Community Pediatrics Doing business as

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
39D1078757Childrens Cmty Pediatrics Greenville90 Shenango Street, Suite #12, Greenville, PA 16125Certificate of waiverJan 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Children's Community Pediatrics62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

90 Shenango St
Ste 12
Greenville, PA 16125
Phone (724) 589-0290

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1558546366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BRADFORD RD STE 200",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906910",
            "telephone_number": "724-933-1100",
            "fax_number": "724-933-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SHENANGO ST STE 12",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252060",
            "telephone_number": "724-589-0290",
            "fax_number": "724-589-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS COMMUNITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR III",
        "authorized_official_telephone_number": "724-933-1100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Childrens Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.