Active NPI
Steven Peter Noll, DO
- Anesthesiology Physician
- Edgewood, KY
National Provider Identifier
1336120039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 02200
- Practice address
- 1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403 - Phone
- (859) 341-7246
- Fax
- (859) 341-7867
- NPI assigned
- Nov 9, 2005
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 02200 | KY | Primary |
Addresses
Primary practice location
1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403
Mailing address
20 Medical Villiage Dr
Ste 258
Edgewood, KY 41017
Phone (859) 341-7246
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000033280 | Other | ANTHEM BLUE SHIELD | |
| 0958870 | Other | OH | MEDICAID |
| 10826428 | Other | CAQH | |
| 2532691 | Other | CIGNA | |
| 64022007 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02200 | KY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Group Practice, Inc | Anesthesiology | Current | Accepting new patients |
Locations
340 Thomas More Pkwy
Ste 220
Crestview Hills, KY 41017
Phone (859) 301-2211
1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000
Organizations & group practices 1
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": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1336120039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MEDICAL VILLIAGE DR",
"address_2": "STE 258",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "41017",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL VILLAGE DR",
"address_2": "INDEPENDENT ANESTHESIOLOGISTS PSC",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173403",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLL",
"first_name": "STEVEN",
"middle_name": "PETER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "02200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "000000033280",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "0958870",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10826428",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2532691",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64022007",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
- Samuel S Newman, M.D.
- Jade Nicole Nicely, MD
- Balaji Nithianandam, MD
- Jessica Noble, APRN
- Thomas E Nogueira, M.D.
- James Andrew Northcutt, LCSW
- Northern Kentucky Independent District Health Dept
- Northern Ky Oral & Maxillofacial Surgery Associates (No Ky Oral & Maxillofacial Surgery)
- Patrick Michael Nutini, DMD
- Emily Marie O'Brien
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.