UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP (NPI# 1902292899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902292899 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP |
| Practice Address |
100 Highland Ave Suite 201 Providence RI 02906-2740 |
| Practice Telephone | 4016331100 |
| Practice Fax Number | 4016330047 |
| Mailing Telephone | 4016331100 |
| Mailing Fax Number | 4016330047 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |
| Authorized Official Name | MR. CHARLES M WHEELER III (PEDIATRIC NURSE PRACTIONER) |
| Authorized Official Telephone | 4016331100 |
| Authorized Official Credential | PPCNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APRN00401 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 HIGHLAND AVE SUITE 201 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670044 | Elizabeth L Altenhein | Surgery | 100 Highland Ave, Ste 308, Providence, RI 02906-2740 | 2005-06-21 |
| 1063817963 | Stephanie Sachs | Massage Therapist | 100 Highland Ave, Suite 102, Providence, RI 02906-2740 | 2014-11-04 |
| 1972916229 | Community Health and Immunization Services | Community Health Worker | 100 Highland Ave, Suite 303, Providence, RI 02906-2753 | 2014-06-04 |
| 1851721740 | Passport Health Holdings LLC | Clinic/Center | 100 Highland Ave, Suite 303, Providence, RI 02906-2753 | 2013-11-14 |
| 1306274584 | Brianna Leigh Boulanger | Massage Therapist | 100 Highland Ave, Suite 102, Providence, RI 02906 | 2013-10-24 |
| 1306123476 | Providence Interventional Associates II LLC | Internal Medicine | 100 Highland Ave, Providence, RI 02906-2740 | 2011-11-03 |
| 1912207887 | Providence Interventional Associates LLC | Clinic/Center | 100 Highland Ave, Providence, RI 02906-2740 | 2010-10-26 |
| 1942528658 | Margaret M Dyer | Pediatrics | 100 Highland Ave, Providence, RI 02906-2740 | 2010-05-06 |
| 1043447097 | Vorawan Ummaritchot | Internal Medicine | 100 Highland Ave, Suite 203, Providence, RI 02906-2740 | 2009-06-17 |
| 1346442563 | Man Chin Chang | Internal Medicine | 100 Highland Ave, Suite 203, Providence, RI 02906-2740 | 2007-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225205206 | Sarah M Gay | Nurse Practitioner | 1 Hoppin St Ste 304, Providence, RI 02903-4141 | 2008-05-09 |
| 1083811376 | Martha J Mance | Nurse Practitioner | 100 Highland Ave Ste 302, Providence, RI 02906-2753 | 2007-06-29 |
| 1255387189 | Janet Trotta Pardy | Nurse Practitioner | 593 Eddy Street Mph 131, Rhode Island Hospital, Providence, RI 02903 | 2006-05-25 |
| 1487210068 | Stephanie Watt | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2019-05-19 |
| 1639689060 | Sarah Pothier | Nurse Practitioner | 593 Eddy St, Providence, RI 02903 | 2017-10-12 |
| 1083154850 | Miranda Mitchell | Nurse Practitioner | 593 Eddy St, Adolescent Medicine, Providence, RI 02903-4923 | 2017-02-27 |
| 1588112858 | Christina Martins | Nurse Practitioner | 593 Eddy St, Claverick 2, Providence, RI 02903-4923 | 2016-09-15 |
| 1063882538 | Tina M Taylor | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2015-09-28 |
| 1619350030 | Michaela Procaccini | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2015-07-02 |
| 1568878627 | Elizabeth Noreen Mintzes | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2014-07-09 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
Please comment or provide details below to improve the information on UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP.
| 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.