Individual provider Active NPI

Wiaam Taha, M.D.

  • Internal Medicine Physician
  • Hartland, WI
National Provider Identifier
1487103198
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27547 Issued in WI
Practice address
600 Walnut Ridge Dr
Hartland, WI 53029
Phone
(262) 369-7040
Fax
(262) 369-7041
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27547 WI Primary

Addresses

Primary practice location

600 Walnut Ridge Dr
Hartland, WI 53029

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 389-2338

Other practice location 1

816 22nd Ave. Suite 100
Kearney, NE 68845-2206
Phone (308) 865-2263

Other identifiers 1

IdentifierTypeStateIssuer
100086184MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wtaha224046@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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

LicenseStateTypeSpecialty
27547WIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: wtaha224046@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1487103198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2338",
            "fax_number": "414-385-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WALNUT RIDGE DR",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "262-369-7040",
            "fax_number": "262-369-7041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "816 22nd Ave. Suite 100",
            "address_purpose": "LOCATION",
            "city": "Kearney",
            "state": "NE",
            "postal_code": "688452206",
            "country_code": "US",
            "telephone_number": "308-865-2263",
            "fax_number": "308-865-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAHA",
        "first_name": "WIAAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "27547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100086184",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtaha224046@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "600 Walnut Ridge Dr",
            "city": "Hartland",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "600 Walnut Ridge Dr",
            "city": "Hartland",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.