Active NPI
Daniel Trevor Noonan, MT
- Contractor
- Glenwood Springs, CO
National Provider Identifier
1376844647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 9399
- Practice address
- 1517 Crawford Way
Glenwood Springs, CO 81601-4577 - Phone
- (970) 309-8721
- NPI assigned
- Nov 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 9399 | CO | Primary |
Addresses
Primary practice location
1517 Crawford Way
Glenwood Springs, CO 81601-4577
Mailing address
1517 Crawford Way
Glenwood Springs, CO 81601-4577
Phone (970) 309-8721
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 969209 | Other | CO | ASSOCIATED BODYWORK & MASSAGE PROFESSIONALS |
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
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9399 | CO | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1376844647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1517 CRAWFORD WAY",
"city": "GLENWOOD SPRINGS",
"state": "CO",
"postal_code": "816014577",
"telephone_number": "970-309-8721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 CRAWFORD WAY",
"city": "GLENWOOD SPRINGS",
"state": "CO",
"postal_code": "816014577",
"telephone_number": "970-309-8721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOONAN",
"first_name": "DANIEL",
"middle_name": "TREVOR",
"name_prefix": "Mr.",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-03",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CO",
"license": "9399",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOCIATED BODYWORK & MASSAGE PROFESSIONALS",
"identifier": "969209",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glenwood Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.