NPIMap

Organization Active NPI

Children's Medical Group

Doing business as Northside YMCA

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1972845931
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CHILDREN'S MEDICAL GROUP
Doing business as
Northside YMCA
Practice address
1350 W North Ave
Milwaukee, WI 53205-1257
Phone
(414) 431-9559
Fax
(414) 431-9562
NPI assigned
Mar 18, 2013
Organization subpart
Yes
Parent organization
CHILDREN'S MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Authorized official

Name
Dr. Smriti Khare, M.D.
Title
President, Children's Medical Group
Phone
(414) 266-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1350 W North Ave
Milwaukee, WI 53205-1257

Mailing address

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

Other names 1

  • Northside YMCA 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

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1972845931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MAIL STATION 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": "1350 W NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051257",
            "telephone_number": "414-431-9559",
            "fax_number": "414-431-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S MEDICAL GROUP",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "KHARE",
        "authorized_official_first_name": "SMRITI",
        "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": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside YMCA",
            "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 Oct 4, 2013; 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.