CHILDREN'S MEDICAL GROUP NPI 1174999163

NPI Information

NPI: 1174999163
Provider Name: CHILDREN'S MEDICAL GROUP
Classification: Pediatrics - 208000000X
Entity Type: Organization
Doing Business As: CEDARBURG PEDIATRICS
Address: 7861 STATE ROAD 60
CEDARBURG, WI
ZIP 53012
Phone: (262) 546-1050

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NPI Details

CHILDREN'S MEDICAL GROUP is a pediatrics in Cedarburg, 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 1174999163. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cedarburg Pediatrics.

The provider's business location address is:

7861 STATE ROAD 60
CEDARBURG, WI
ZIP 53012-305
Phone: (262) 546-1050
Fax: (262) 546-1051

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

The enumeration date for this NPI number is 8/13/2015 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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	101YP2500X	Counselor	Professional	No
3	103TC2200X	Psychologist	Clinical Child & Adolescent	No
4	104100000X	Social Worker		No
5	1041C0700X	Social Worker	Clinical	No
6	106H00000X	Marriage & Family Therapist		No
7	2084P0800X	Psychiatry & Neurology	Psychiatry	No
8	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
9	208000000X	Pediatrics		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1174999163	MEDICAID	WISCONSIN

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: 11/21/2025

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