NPIMap

Organization Active NPI

Children'S Health System, Inc.

  • Urgent Care Clinic/Center
  • Kenosha, WI
National Provider Identifier
1780155275
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CHILDREN'S HEALTH SYSTEM, INC.
Practice address
6809 122ND Avenue
Kenosha, WI 54342-7335
Phone
(262) 891-6600
Fax
(262) 891-6602
NPI assigned
Dec 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Authorized official

Name
Marc Cadieux
Title
Corp VP & Chief Financial Officer
Phone
(414) 266-6226

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

6809 122ND Avenue
Kenosha, WI 54342-7335

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1780155275MedicaidWI

Other names 1

  • Children's Urgent Care - Kenosha Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children'S Hospital and Health System Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545782400000",
    "number": "1780155275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 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": "6809 122ND AVENUE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "543427335",
            "telephone_number": "262-891-6600",
            "fax_number": "262-891-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-26",
        "status": "A",
        "authorized_official_last_name": "CADIEUX",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CORP VP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "414-266-6226"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780155275",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Urgent Care - Kenosha",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Urgent Care - Kenosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.