Active NPI
Nolan M Segal, M.D.
- Specialist
- St Louis Park, MN
National Provider Identifier
1285837104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 22951
- Practice address
- 6465 Wayzata Blvd
Suite 900
St Louis Park, MN 55426-1728 - Phone
- (952) 236-7266
- Fax
- (952) 236-7212
- NPI assigned
- Jun 7, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 22951 | MN | Primary |
Addresses
Primary practice location
6465 Wayzata Blvd
Suite 900
St Louis Park, MN 55426-1728
Mailing address
6465 Wayzata Boulevard
Suite 900
St Louis Park, MN 55426-1734
Phone (952) 236-7266
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 271210500 | Medicaid | MN | |
| 03388DA | Other | MN | BLUE CROSS BLUE SHIELD MN |
| 0929927 | Other | MN | MEDICA |
| C808 | Other | MN | UCARE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22951 | MN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1285837104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6465 WAYZATA BOULEVARD",
"address_2": "SUITE 900",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261734",
"telephone_number": "952-236-7266",
"fax_number": "952-236-7212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6465 WAYZATA BLVD",
"address_2": "SUITE 900",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261728",
"telephone_number": "952-236-7266",
"fax_number": "952-236-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEGAL",
"first_name": "NOLAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "22951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "271210500",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "03388DA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0929927",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "C808",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.