Active NPI
Noel Pillman, MD
- Emergency Medicine Physician
- Coon Rapids, MN
National Provider Identifier
1003877788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 26295
- Practice address
- 4050 Coon Rapids Blvd
Mercy Medical Center
Coon Rapids, MN 55433 - Phone
- (763) 236-7144
- Fax
- (763) 236-7733
- NPI assigned
- Mar 31, 2006
- Reactivated
- Jun 13, 2013
- Last updated
- Jun 13, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 26295 | MN | Primary |
Addresses
Primary practice location
4050 Coon Rapids Blvd
Mercy Medical Center
Coon Rapids, MN 55433
Mailing address
7301 Ohms Lane
Suite 650
Edina, MN 55439
Phone (952) 835-9880
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26295 | Other | MN | MEDICAL LICENSE |
| 156763200 | Medicaid | MN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26295 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians Professional Association | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba The Urgency Room - Golden Valley
- Urgent Care Clinic/Center
- Golden Valley, MN
- NPI 1750188488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1003877788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 OHMS LANE",
"address_2": "SUITE 650",
"city": "EDINA",
"state": "MN",
"postal_code": "55439",
"telephone_number": "952-835-9880",
"fax_number": "952-857-1554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 COON RAPIDS BLVD",
"address_2": "MERCY MEDICAL CENTER",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "55433",
"telephone_number": "763-236-7144",
"fax_number": "763-236-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILLMAN",
"first_name": "NOEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2013-06-13",
"deactivation_date": "2006-07-19",
"reactivation_date": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "26295",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "26295",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "156763200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.