Tim Gilbert Harder, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28468 Issued in WI

Practice address

3860 Monroe Rd
De Pere, WI 54115-8399

Phone

(920) 496-4700

Fax

(920) 431-1970

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1922032580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "address_2": "PREVEA HEALTH",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 MONROE RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158399",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDER",
        "first_name": "TIM",
        "middle_name": "GILBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "28468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30838700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Jean Haker
• Michelle M Hall, LMT
• Amy Handler, OTR
• Gage Hannot, DPT
• Steven P Hansen, D.C.
• Harris Chiropractic
• Paul M Harris, D.C.
• Tess Harris
• Christen Hathaway, LMFT-IT
• Jaceson L. Hauser, DC

• Pediatrics Physician in De Pere, WI
• Providers in De Pere, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.