CHILDREN'S MEDICAL GROUP (NPI# 1205001468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205001468 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S MEDICAL GROUP |
| Other Organization Name | MAYFAIR PEDIATRICS |
| Practice Address |
3040 N 117th St Wauwatosa WI 53222-4128 |
| Mailing Address |
9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 4144799990 |
| Practice Fax Number | 4144790230 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142661853 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | DR. SMRITI KHARE (PRESIDENT, CHILDREN'S MEDICAL GROUP) |
| Authorized Official Telephone | 4142667615 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32844900 | 05 |
| Other Name | Type Code |
|---|---|
| Mayfair Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1700222981 | Children's Medical Group | Counselor | 7300 S 13th St, Suite 201, Oak Creek, WI 53154-1832 | 2013-05-15 |
| 1275708539 | Children's Medical Group | Pediatrics | 24906 75th St, Salem, WI 53168-9705 | 2008-04-28 |
| 1174999163 | Children's Medical Group | Pediatrics | 7861 State Road 60, Cedarburg, WI 53012-9305 | 2015-08-13 |
| 1992171987 | Children's Medical Group | Pediatrics | 611 Veterans Ave Ste 106, West Bend, WI 53090-2545 | 2015-08-13 |
| 1174999262 | Children's Medical Group | Pediatrics | 8800 Washington Ave, Suite 300, Mount Pleasant, WI 53406-3701 | 2015-08-12 |
| 1497154538 | Children's Medical Group | Pediatrics | 7322 W Rawson Ave, Franklin, WI 53132-8104 | 2014-08-14 |
| 1831502327 | Children's Medical Group | Pediatrics | 3365 S 103rd St Ste 210, Milwaukee, WI 53227-4161 | 2014-06-03 |
| 1417299488 | Children's Medical Group | Nurse Practitioner | 2320 W Burleigh St, Milwaukee, WI 53206-1751 | 2013-03-18 |
| 1972845931 | Children's Medical Group | Nurse Practitioner | 1350 W North Ave, Milwaukee, WI 53205-1257 | 2013-03-18 |
| Street Address |
3040 N 117TH ST |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53222-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419760 | Karen M Wegner | Pediatrics | 3040 N 117th St, Wauwatosa, WI 53222-4107 | 2005-07-07 |
| 1861896029 | Children's Health System | Pediatrics | 3040 N 117th St, Suite 100, Wauwatosa, WI 53222-4128 | 2014-10-17 |
| 1821354044 | Robyn Kathleen Labarge | Pediatrics | 3040 N 117th St, Wauwatosa, WI 53222-4128 | 2012-04-02 |
| 1982970968 | Michael Thomas O'reilly | Pediatrics | 3040 N 117th St, Wauwatosa, WI 53222-4128 | 2012-03-23 |
| 1487944419 | Emilee Yamdagni | Pediatrics | 3040 N 117th St, Wauwatosa, WI 53222-4128 | 2011-04-11 |
| 1871810416 | Renee Marie Zimmermann | Obstetrics & Gynecology | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4128 | 2010-04-21 |
| 1295820959 | Jocelyn K Eiche | Obstetrics & Gynecology | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4129 | 2006-10-04 |
| 1396830089 | Matthew B Lee | Obstetrics & Gynecology | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4128 | 2006-10-04 |
| 1902991680 | Carmen L Terlizzi | Obstetrics & Gynecology | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4129 | 2006-10-04 |
| 1598850299 | Obstetrics & Gynecology, S.c. | Obstetrics & Gynecology | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4128 | 2006-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477101673 | Dalaina Y Holliman | Technician | 7719 W Fiebrantz Ave, Milwaukee, WI 53222 | 2019-08-30 |
| 1083183016 | Umenia Marie White | Respite Care | 7726 W. Center Street, Apt 1, Milwaukee, WI 53222 | 2018-11-20 |
| 1003399445 | For Eyes Optical Co of Pennsylvania | Eyewear Supplier (Equipment, not the service) | 11450 W. Burleigh St, Wauwatosa, WI 53222 | 2018-09-12 |
| 1558852673 | Joseph Fleming | Physical Therapist | 11450 W Burleigh St, Ste 120, Wauwatosa, WI 53222 | 2018-05-24 |
| 1942739206 | Yolanda D. Burdine | Licensed Practical Nurse | 8327 W. Center St., Apt. 2, Milwaukee, WI 53222 | 2017-06-08 |
| 1558807131 | Midwest Nephrology Associates, Sc | Clinic/Center | 7797 W Appleton Avenue, Milwaukee, WI 53222 | 2017-01-06 |
| 1477097269 | Benjamin David Kluge | Pharmacist | 11111 W Burleigh Rd, Wauwatosa, WI 53222 | 2016-12-13 |
| 1841746989 | Elissa Hornick | Physician Assistant | 2885 N. Mayfair Rd., Wauwatosa, WI 53222 | 2016-08-29 |
| 1598218562 | Riley's Residential Home Care, LLC | In Home Supportive Care | 10111 W. Capitol Dr, Wauwatosa, WI 53222 | 2016-07-26 |
| 1346696796 | Respiratory and Sleep Services LLC | Durable Medical Equipment & Medical Supplies | 6529 W Fond Du Lac Avenue, Milwaukee, WI 53222 | 2016-05-04 |
| Find all providers in zip 53222 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356727838 | Ruth Heimlew | Pediatrics | 10705 W. Wisconsin Ave., Wauwatosa, WI 53226-3547 | 2015-08-06 |
| 1760878177 | Ali Hemyari | Pediatrics | 9999 W North Ave Apt 322, Wauwatosa, WI 53226 | 2015-04-13 |
| 1861420184 | H Seid Ashraf | Pediatrics | 949 Glenview Avenue, Wauwatosa, WI 53213 | 2006-06-28 |
| 1336194588 | Hebatollah S Ashraf | Pediatrics | 949 Glenview Ave, Wauwatosa, WI 53213 | 2006-05-24 |
| 1356308191 | Katrina Ubell | Pediatrics | 8651 W North Ave, Wauwatosa, WI 53226-2721 | 2006-04-26 |
| 1376526319 | S. L. Moss, M.d., S.c. | Pediatrics | 10625 W North Ave, Suite 222, Wauwatosa, WI 53226-2315 | 2005-11-23 |
| 1063419760 | Karen M Wegner | Pediatrics | 3040 N 117th St, Wauwatosa, WI 53222-4107 | 2005-07-07 |
| 1710412606 | Riley Simon Boland | Pediatrics | 8701 W Watertown Plank Rd, Wauwatosa, WI 53226-3548 | 2017-04-27 |
| 1861896029 | Children's Health System | Pediatrics | 3040 N 117th St, Suite 100, Wauwatosa, WI 53222-4128 | 2014-10-17 |
| 1154765410 | Southeastern Pediatrics, Sc | Pediatrics | 10625 W North Ave Ste 326, Wauwatosa, WI 53226-2315 | 2013-04-17 |
| Find all providers in WAUWATOSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.