Active NPI
Tahlin Avedian, M.D.
- Family Medicine Physician
- Milwaukee, WI
National Provider Identifier
1194042408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 56554-20
- Practice address
- 2801 W Kinnickinnic River Pkwy
Suite 250
Milwaukee, WI 53215-3669 - Phone
- (414) 649-7909
- Fax
- (414) 649-3361
- NPI assigned
- Apr 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 56554-20 | WI | Primary |
Addresses
Primary practice location
2801 W Kinnickinnic River Pkwy
Suite 250
Milwaukee, WI 53215-3669
Mailing address
1029 N Jackson St
#1004
Milwaukee, WI 53202-3260
Phone (818) 445-3135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56554-20 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1194042408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1029 N JACKSON ST",
"address_2": "#1004",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532023260",
"telephone_number": "818-445-3135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 W KINNICKINNIC RIVER PKWY",
"address_2": "SUITE 250",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-649-7909",
"fax_number": "414-649-3361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVEDIAN",
"first_name": "TAHLIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-26",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "56554-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.