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CHILDREN'S MEDICAL GROUP NPI 1255506598


NPI Information

NPI: 1255506598
Provider Name: CHILDREN'S MEDICAL GROUP

Doing Business As: GOOD HOPE PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 52D0957513

Address:
7720 W GOOD HOPE RD
MILWAUKEE, WI
ZIP 53223
Phone: (414) 536-0236
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CHILDREN'S MEDICAL GROUP is a pediatrics in Milwaukee, WI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CHILDREN'S MEDICAL GROUP NPI is 1255506598. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Good Hope Pediatrics.

The provider's business location address is:

7720 W GOOD HOPE RD
MILWAUKEE, WI
ZIP 53223-516
Phone: (414) 536-0236
Fax: (414) 536-0260

The provider's authorized official is Smriti Khare .
The authorized official title is President, Children's Medical Group and has the following contact phone number (414) 266-7615.

The CLIA number assigned to this NPI record is 52D0957513 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/28/2008 and was last updated on 9/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessionalNo
2103TC2200XPsychologistClinical Child & AdolescentNo
3104100000XSocial WorkerNo
41041C0700XSocial WorkerClinicalNo
5106H00000XMarriage & Family TherapistNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
72084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
8208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
132863700MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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