NPIMap

Organization Active NPI

Childrens Medical Group

  • Pediatrics Physician
  • Hermitage, TN
National Provider Identifier
1760456065
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDRENS MEDICAL GROUP
Doing business as
Children's Medical Group
Practice address
3786 Central Pike Ste 130
Hermitage, TN 37076-3498
Phone
(615) 883-2200
Fax
(615) 883-1104
NPI assigned
Feb 14, 2006
Last updated
May 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Authorized official

Name
Mrs. Elizabeth Fairbank, MDNPI 1316926876
Title
President
Phone
(615) 883-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

3786 Central Pike Ste 130
Hermitage, TN 37076-3498

Mailing address

3786 Central Pike Ste 130
Hermitage, TN 37076-3498
Phone (615) 883-2200

Other identifiers 1

IdentifierTypeStateIssuer
1517825MedicaidTN

Other names 1

  • Children's Medical Group 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
44D0681732Childrens Medical Group PC3786 Central Pike Suite 130, Hermitage, TN 37076Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory

Locations

3786 Central Pike
Ste 130
Hermitage, TN 37076
Phone (615) 883-2200

5651 Frist Blvd
Ste 200
Hermitage, TN 37076
Phone (615) 885-0200

Practitioners & affiliated clinicians

Practitioners 9

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1760456065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3786 CENTRAL PIKE STE 130",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763498",
            "telephone_number": "615-883-2200",
            "fax_number": "615-883-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3786 CENTRAL PIKE STE 130",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763498",
            "telephone_number": "615-883-2200",
            "fax_number": "615-883-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "FAIRBANK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-883-2200",
        "authorized_official_name_prefix": "Mrs.",
        "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": "1517825",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.