Individual provider Active NPI

Tanya M. Hoar, NP

  • Pediatric Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1891933552
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3686-33 Issued in WI
Practice address
6226 14TH Ave
Kenosha, WI 53143-4413
Phone
(262) 656-0044
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3686-33 WI Primary
Registered Nurse 163W00000X 150991-30 WI

Addresses

Primary practice location

6226 14TH Ave
Kenosha, WI 53143-4413

Mailing address

625 57TH St
Suite 700
Kenosha, WI 53140-4146
Phone (262) 764-3622

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3686WIMDOptometrist
150991-30WIMDRegistered Nurse
3686-33WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samir Mullick MD SC PastSince Jun 1, 2003 Accepting new patients

Organizations & group practices 1

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": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1891933552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 57TH ST",
            "address_2": "SUITE 700",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404146",
            "telephone_number": "262-764-3622",
            "fax_number": "262-925-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 14TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434413",
            "telephone_number": "262-656-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOAR",
        "first_name": "TANYA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "3686-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "150991-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.