Active NPI
Kirk I O'Hanison, NP
- Nurse Practitioner
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 10431
- Practice address
- 11333 W National Ave
Milwaukee, WI 53227-3111 - Phone
- (414) 329-4979
- NPI assigned
- Oct 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10431-33 | WI | |
| Nurse Practitioner | 363L00000X | 10431 | WI | Primary |
Addresses
Primary practice location
11333 W National Ave
Milwaukee, WI 53227-3111
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
17043 W Greenfield Ave
New Berlin, WI 53151-1364
Phone (262) 505-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100182435 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kohanison56857@direct.myadvocateaurora.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3509 Dewey St
Manitowoc, WI 54220-5813
Phone (920) 686-5731
Hospital & facility affiliations
- Aurora at Home
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10431-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
3509 Dewey St
Manitowoc, WI 54220
Phone (920) 686-5731
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
11333 W National Ave
West Allis, WI 53227
Phone (414) 327-2295
Interoperability endpoints
- kohanison56857@direct.myadvocateaurora.org
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- West Allis, WI
- NPI 1134255037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1649877663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11333 W NATIONAL AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532273111",
"telephone_number": "414-329-4979"
}
],
"practiceLocations": [
{
"address_1": "17043 W Greenfield Ave",
"address_purpose": "LOCATION",
"city": "New Berlin",
"state": "WI",
"postal_code": "531511364",
"country_code": "US",
"telephone_number": "262-505-6260",
"fax_number": "262-505-6261",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'HANISON",
"first_name": "KIRK",
"middle_name": "I",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-02",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "10431-33",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "10431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100182435",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kohanison56857@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "6030 W Oklahoma Ave",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532194133",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.