Jerrol Jay Noller, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23068 Issued in MN

Practice address

3863 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2518

Phone

(763) 433-8300

Fax

(763) 433-8308

NPI assigned

Aug 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jerrol Noller MD LTD

  • Medical Specialty Clinic/Center
  • Coon Rapids, MN
  • NPI 1821257593
  Authorized official Same address or phone

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245343011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 OAKWOOD DR",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032747",
            "telephone_number": "763-427-6897",
            "fax_number": "763-433-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332518",
            "telephone_number": "763-433-8300",
            "fax_number": "763-433-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLER",
        "first_name": "JERROL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "23068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Nied, PHARMD
• Laura Nielsen
• Fatima Nisar, MBBS
• Tinashe Patience Nkhoma
• Kristen Nold, PTA
• Allison Sheldon Nommensen
• Shirley V Nordahl, BSN, CPNP
• Matthew Paul Nordby, PA
• Nordin Eye Care Associates Inc
• Madeleine Ann Nordness, DPT

• Internal Medicine Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.