NPIMap

Organization Active NPI

Children'S Medical Group

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1891960027
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S MEDICAL GROUP
Practice address
2025 W Oklahoma Ave
Suite 105
Milwaukee, WI 53215-4455
Phone
(414) 385-9638
Fax
(414) 385-9412
NPI assigned
Apr 29, 2008
Organization subpart
Yes
Parent organization
CHILDREN'S MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Thomas Dunigan, MD
Title
President, Children'S Medical Group
Phone
(414) 266-7615

Specialties & licenses 1

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

Addresses

Primary practice location

2025 W Oklahoma Ave
Suite 105
Milwaukee, WI 53215-4455

Mailing address

9000 W Wisconsin Ave
Ms 8000
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other identifiers 1

IdentifierTypeStateIssuer
32873900MedicaidWI

Other names 1

  • Pavilion Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Childrens Medical Group Inc38 organizations share this tax ID, including this one
Part of
Childrens Medical Group Inc

Other organizations with this tax ID 37

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

View all 37

Locations

2025 W Oklahoma Ave
Ste 105
Milwaukee, WI 53215
Phone (414) 385-9638

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1891960027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 8000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W OKLAHOMA AVE",
            "address_2": "SUITE 105",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154455",
            "telephone_number": "414-385-9638",
            "fax_number": "414-385-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL GROUP",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "DUNIGAN",
        "authorized_official_first_name": "THOMAS",
        "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": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32873900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pavilion Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.