Individual provider Active NPI

Carrie Lyn Noonan, NP-C

  • Family Nurse Practitioner
  • Creve Coeur, MO
National Provider Identifier
1114339470
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014004541 Issued in MO
Practice address
11560 Olive Blvd
Minuteclinic
Creve Coeur, MO 63141-7111
Phone
(314) 995-7128
NPI assigned
May 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10051813 OR
Family Nurse Practitioner 363LF0000X 5607 HI
Family Nurse Practitioner 363LF0000X 142493974405 UT
Family Nurse Practitioner 363LF0000X 70055290 WA
Family Nurse Practitioner 363LF0000X 269119 MT
Family Nurse Practitioner 363LF0000X 246249 AK
Family Nurse Practitioner 363LF0000X 2014004541 MO Primary
Registered Nurse 163W00000X 2009019269 MO
Family Nurse Practitioner 363LF0000X 85265 NM
Family Nurse Practitioner 363LF0000X 332033 AZ
Family Nurse Practitioner 363LF0000X 209011328 IL
Family Nurse Practitioner 363LF0000X 13903 MN

Addresses

Primary practice location

11560 Olive Blvd
Minuteclinic
Creve Coeur, MO 63141-7111

Mailing address

11560 Olive Blvd
Creve Coeur, MO 63141-7111
Phone (618) 520-4512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NM, UT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170313001058 IL Practitioner - Nurse Practitioner 3274759642 Reassigns benefits to 1 organization
I20251025000217 NM Practitioner - Nurse Practitioner 3274759642 Reassigns benefits to 1 organization
I20251121002421 UT Practitioner - Nurse Practitioner 3274759642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of New Mexico, LLCGroup PAC ID 7517280266, 10 clinicians

Practice addresses (Care Compare)

4340 San Mateo Blvd NE
Albuquerque, NM 87110-1234
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13903MNMDClinical Social Worker
2009019269MOMDRegistered Nurse
246249AKMDFamily Nurse Practitioner
332033AZMDFamily Nurse Practitioner
5607HIMDFamily Nurse Practitioner
209011328ILMDFamily Nurse Practitioner
2014004541MOMDFamily Nurse Practitioner
269119MTMDFamily Nurse Practitioner
85265NMMDFamily Nurse Practitioner
10051813ORMDFamily Nurse Practitioner
142493974405UTMDFamily Nurse Practitioner
70055290WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Jul 25, 2014 Accepting new patients
Minuteclinic Diagnostic of New Mexico, LLC Family CurrentSince Oct 14, 2025 Accepting new patients
Minuteclinic Video Virtual Care North, LLC Family CurrentSince Oct 9, 2025 Accepting new patients
Minuteclinic Diagnostic of Utah, LLC Family CurrentSince Nov 6, 2025 Accepting new patients

Locations

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

3825 S Noland Rd
Independence, MO 64055
Phone (816) 254-6002

11560 Olive Blvd
Saint Louis, MO 63141
Phone (314) 892-8352

8021 Watson Rd
Webster Groves, MO 63119
Phone (314) 963-0398

4340 San Mateo Blvd NE
Albuquerque, NM 87110
Phone (505) 252-0599

9640 Menaul Blvd NE
Albuquerque, NM 87112
Phone (505) 294-4167

7777 S Redwood Rd
West Jordan, UT 84084
Phone (801) 255-9077

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1114339470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417111",
            "telephone_number": "618-520-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 OLIVE BLVD",
            "address_2": "MINUTECLINIC",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417111",
            "telephone_number": "314-995-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "CARRIE",
        "middle_name": "LYN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10051813",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "5607",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "142493974405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "70055290",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "269119",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "246249",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014004541",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009019269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "85265",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "332033",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011328",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.