Active NPI
Peter S Nolan, MD
- Pediatrics Physician
- Mankato, MN
National Provider Identifier
1366421356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23067
- Practice address
- 1230 E Main Street
Mankato Clinic @ Main Street
Mankato, MN 56002-8674 - Phone
- (507) 625-1811
- NPI assigned
- Jan 10, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23067 | MN | Primary |
Addresses
Primary practice location
1230 E Main Street
Mankato Clinic @ Main Street
Mankato, MN 56002-8674
Mailing address
1230 E Main St
PO Box 8674 Mankato Clinic LTD
Mankato, MN 56002-8674
Phone (507) 625-1811
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41084933956001C050 | Other | CHAMPUS | |
| 41485NO | Other | MN | BCBS |
| 1202178 | Other | MN | MEDICA |
| 895687 | Other | MN | AMERICAS PPO |
| HP25857 | Other | MN | HEALTH PARTNERS |
| 938241 | Medicaid | IA | |
| 112538 | Other | MN | UCARE |
| NA2951023848 | Other | MN | PREFERRED ONE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23067 | MN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366421356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "PO BOX 8674 MANKATO CLINIC LTD",
"city": "MANKATO",
"state": "MN",
"postal_code": "560028674",
"telephone_number": "507-625-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E MAIN STREET",
"address_2": "MANKATO CLINIC @ MAIN STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "560028674",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "PETER",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "23067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "41084933956001C050",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "41485NO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1202178",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "895687",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25857",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "938241",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "112538",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA2951023848",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.