RIVER GLEN PEDIATRICS – NPI #1710152954
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.

RIVER GLEN PEDIATRICS is a provider located in GLENDALE, WI. NPPES has assigned the NPI number 1710152954 to RIVER GLEN PEDIATRICS on April 29, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “RIVER GLEN PEDIATRICS” is a dba name, the actual legal business name for this organization is CHILDREN'S MEDICAL GROUP. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 5 years ago on Sep 27, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RIVER GLEN PEDIATRICS below.

NPI Profile for
CHILDREN'S MEDICAL GROUP

NPI Number
1710152954
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHILDREN'S MEDICAL GROUP
Doing Business As (dba): RIVER GLEN PEDIATRICS
Primary location
4655 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53212-1076
Phone: (414) 247-9530 Fax: (414) 247-1875
Mailing address
9000 W WISCONSIN AVE
MS 958
MILWAUKEE, WI 53226-4874
Phone: (414) 266-7615 Fax: (414) 266-1853
Organization Subpart
Yes - RIVER GLEN PEDIATRICS is subpart of another organization.
Authorized Official
SMRITI KHARE
PRESIDENT, CHILDREN'S MEDICAL GROUP
Phone: (414) 266-7615
Updated
Certification Date
Sep 27, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for RIVER GLEN PEDIATRICS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI1710152954
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.