University Pediatrics Dba Children'S Medical Group

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN00401 Issued in RI

Legal business name

UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP

Practice address

100 Highland Ave
Suite 201
Providence, RI 02906-2740

Phone

(401) 633-1100

Fax

(401) 633-0047

NPI assigned

Apr 8, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Charles M Wheeler III, PPCNP-BC

Title

Pediatric Nurse Practioner

Phone

(401) 633-1100

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathryn B Eden, MSW LICSW

  • Clinical Social Worker
  • Providence, RI
  • NPI 1649243981
  NPD (past)
• Angela Susan Rudner, LCSWC

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1831408558
  NPD (past)

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1902292899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-633-1100",
            "fax_number": "401-633-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-633-1100",
            "fax_number": "401-633-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PEDIATRIC NURSE PRACTIONER",
        "authorized_official_telephone_number": "401-633-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PPCNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN00401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Rhode Island
• University Orthopedics, Inc.
• University Orthopedics, Inc.
• University Otolaryngology-Head and Neck Surgery, Inc.
• University Pathologists, LLC
• University Pediatrics, Inc
• University Plastic Surgeons Inc
• University Shuttle LLC
• University Surgical Associates, Inc.
• University Urological Associates, Inc.

• All providers in Providence, RI
• Pediatric Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.