Active NPI
Tanya M. Hoar, NP
- Pediatric Nurse Practitioner
- Kenosha, WI
National Provider Identifier
1891933552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 3686-33
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3686 | WI | MD | Optometrist |
| 150991-30 | WI | MD | Registered Nurse |
| 3686-33 | WI | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samir Mullick MD SC | Past | 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.
-
- Pediatrics Physician
- Milwaukee, WI
- NPI 1235182221
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.