Individual provider Active NPI

Tyler James Hanak, CNIM

  • EEG Technician
  • Ann Arbor, MI
National Provider Identifier
1740554872
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EEG TechnicianTaxonomy code 2472E0500X
Practice address
812 Avis Dr
Ann Arbor, MI 48108-9649
Phone
(734) 213-3920
NPI assigned
Mar 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EEG Technician 2472E0500X Primary

Addresses

Primary practice location

812 Avis Dr
Ann Arbor, MI 48108-9649

Mailing address

186 T St
Salt Lake City, UT 84103-4152

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1740554872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 T ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841034152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 AVIS DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089649",
            "telephone_number": "734-213-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAK",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "CNIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.