Individual provider Active NPI

Tanya Sue Huckshold, APRN-CNP

  • Family Nurse Practitioner
  • Alliance, OH
National Provider Identifier
1003484643
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029277 Issued in OH
Practice address
1939 W State St
Alliance, OH 44601-3522
Phone
(330) 238-4455
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0029277 OH Primary

Addresses

Primary practice location

1939 W State St
Alliance, OH 44601-3522

Mailing address

1430 Oak CT Ste 100
Beavercreek, OH 45430-1064
Phone (937) 404-1101

Other practice location 1

715 E Western Reserve Rd
Poland, OH 44514-3358
Phone (330) 726-3204

Other practice location 2

4990 Mahoning Ave
Austintown, OH 44515-1757
Phone (330) 992-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817003227 OH Practitioner - Nurse Practitioner 3072918804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Specialists, LLCGroup PAC ID 1850311010, 81 clinicians

Practice addresses (Care Compare)

6210 Brandt Pike
Huber Heights, OH 45424-4019
Phone (937) 236-8630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Integrated Health, LLC CurrentSince Sep 7, 2021 Accepting new patients
Urgent Care Specialists, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

1939 W State St
Alliance, OH 44601
Phone (330) 238-4455

1430 Oak Ct
Ste 100
Beavercreek, OH 45430
Phone (937) 404-1101

9150 N Main St
Englewood, OH 45415
Phone 9377713039 ext. 937

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066

914 Trailwood Dr
Youngstown, OH 44512
Phone (330) 758-6440

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1003484643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OAK CT STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301064",
            "telephone_number": "937-404-1101",
            "fax_number": "937-404-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 W STATE ST",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446013522",
            "telephone_number": "330-238-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 E Western Reserve Rd",
            "address_purpose": "LOCATION",
            "city": "Poland",
            "state": "OH",
            "postal_code": "445143358",
            "country_code": "US",
            "telephone_number": "330-726-3204",
            "fax_number": "330-729-9316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4990 Mahoning Ave",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445151757",
            "country_code": "US",
            "telephone_number": "330-992-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKSHOLD",
        "first_name": "TANYA",
        "middle_name": "SUE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.