Individual provider Active NPI

Katherine R. Noeller, DPM

  • Foot & Ankle Surgery Podiatrist
  • Murrieta, CA
National Provider Identifier
1083724330
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E2997 Issued in CA
Practice address
25405 Hancock Ave Ste 105
Murrieta, CA 92562-5978
Phone
(951) 677-1323
Fax
(888) 716-6560
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E2997 CA Primary

Addresses

Primary practice location

25405 Hancock Ave Ste 105
Murrieta, CA 92562-5978

Mailing address

25405 Hancock Ave Ste 105
Murrieta, CA 92562-5978
Phone (951) 677-1323

Other identifiers 1

IdentifierTypeStateIssuer
000E29970MedicaidCA

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1083724330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25405 HANCOCK AVE STE 105",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625978",
            "telephone_number": "951-677-1323",
            "fax_number": "888-716-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25405 HANCOCK AVE STE 105",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625978",
            "telephone_number": "951-677-1323",
            "fax_number": "888-716-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOELLER",
        "first_name": "KATHERINE",
        "middle_name": "R.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E29970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.