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CHILDREN'S MEDICAL GROUP NPI 1285809418


NPI Information

NPI: 1285809418
Provider Name: CHILDREN'S MEDICAL GROUP

Doing Business As: BLUEMOUND PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
12635 W. BLUEMOUND ROAD
BROOKFIELD, WI
ZIP 53005
Phone: (414) 258-0606
Get Directions

CHILDREN'S MEDICAL GROUP is a pediatrics in Brookfield, 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 1285809418. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bluemound Pediatrics.

The provider's business location address is:

12635 W. BLUEMOUND ROAD
BROOKFIELD, WI
ZIP 53005-004
Phone: (414) 258-0606
Fax: (414) 258-1953

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 enumeration date for this NPI number is 4/29/2008 and was last updated on 11/18/2021.


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
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessionalNo
3103TC2200XPsychologistClinical Child & AdolescentNo
4104100000XSocial WorkerNo
51041C0700XSocial WorkerClinicalNo
6106H00000XMarriage & Family TherapistNo
72084P0800XPsychiatry & NeurologyPsychiatryNo
82084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
9208000000XPediatricsYes

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
132846000MEDICAIDWISCONSIN

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: 11/14/2023

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