NPIMap

Organization Active NPI

Children's Clinic Network

Doing business as Metropolitan Pediatric Specialists

  • Primary Care Clinic/Center
  • Edina, MN
National Provider Identifier
1578830733
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CHILDREN'S CLINIC NETWORK
Doing business as
Metropolitan Pediatric Specialists
Practice address
6517 Drew Avenue South
Edina, MN 55435-2103
Phone
(952) 920-9191
NPI assigned
Nov 16, 2011
Last updated
Oct 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Brenda Lu Alexander McCormick
Title
Sr. VP and Chief Financial Officer
Phone
(612) 813-6129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MN Primary

Addresses

Primary practice location

6517 Drew Avenue South
Edina, MN 55435-2103

Mailing address

5901 Lincoln Drive
CBC-2-Rev/Pe
Edina, MN 55436-1611
Phone (952) 992-5691

Other names 1

  • Metropolitan Pediatric Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130214000538 MN Part B Supplier - Clinic/Group Practice 5890949192 Receives reassigned benefits from 62 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West St Paul, MN; West Saint Paul, MN; Saint Louis Park, MN; Rogers, MN; Minnetonka, MN; Maple Grove, MN; Hugo, MN; Brooklyn Park, MN

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1578830733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 LINCOLN DRIVE",
            "address_2": "CBC-2-REV/PE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361611",
            "telephone_number": "952-992-5691",
            "fax_number": "952-992-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6517 DREW AVENUE SOUTH",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352103",
            "telephone_number": "952-920-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "BRENDA LU",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "SR. VP AND CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "612-813-6129"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metropolitan Pediatric Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metropolitan Pediatric Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.