P J Noss Corporation

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

P J NOSS CORPORATION

Practice address

1924 Dunedin Ave
Duluth, MN 55803-2400

Phone

(218) 312-3002

Fax

(218) 236-8933

NPI assigned

Feb 26, 2016

Organization subpart

No

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

Authorized official

Name

Phyllis J Noss, M.D.NPI 1487745253

Title

Owner

Phone

(218) 310-8050

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PJ Noss LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phyllis Noss, M.D.

  • Diagnostic Radiology Physician
  • Duluth, MN
  • NPI 1487745253
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114387529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 DUNEDIN AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558032400",
            "telephone_number": "218-310-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 DUNEDIN AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558032400",
            "telephone_number": "218-312-3002",
            "fax_number": "218-236-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E 25th St",
            "address_purpose": "LOCATION",
            "city": "Hibbing",
            "state": "MN",
            "postal_code": "557463897",
            "country_code": "US",
            "telephone_number": "218-312-3002",
            "fax_number": "218-263-8933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "P J NOSS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NOSS",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-310-8050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114387529",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1114387529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PJ Noss LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Diagnostic Radiology Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.