MEDICARE: CHILDREN'S COMMUNITY PRACTICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386031896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S COMMUNITY PRACTICES, LLC

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 S TRIMBLE RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3418
Country	:	US
Telephone Number	:	419-522-5454
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	PATRICIA J MCCLIMON
Credential	:
Telephone Number	:	614-722-5114

Provider Enumeration Date	:	04/22/2015
Last Update Date	:	04/08/2026

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Directions to “CHILDREN'S COMMUNITY PRACTICES, LLC ” Practice Location

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