Individual provider Active NPI

Ronald E Nolley Jr., M.D.

  • Diagnostic Radiology Physician
  • Enid, OK
National Provider Identifier
1427004993
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20457 Issued in OK
Practice address
305 S 5TH St
Enid, OK 73701-5832
Phone
(580) 234-2878
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20457 OK Primary

Addresses

Primary practice location

305 S 5TH St
Enid, OK 73701-5832

Mailing address

720 W Maine Ave
Enid, OK 73701-5414

Other identifiers 2

IdentifierTypeStateIssuer
P00324168OtherOKRR MEDICARE
100027580AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000856 OK Practitioner - Diagnostic Radiology 4688664840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 S 5TH St
Enid, OK 73701-5832
Phone (580) 233-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20457OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Area Radiological Consultants PA Diagnostic Radiology Past Accepting new patients
Uhs of Oklahoma Inc Diagnostic Radiology Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Organizations & group practices 4

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1427004993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W MAINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S 5TH ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015832",
            "telephone_number": "580-234-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLEY",
        "first_name": "RONALD",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "20457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00324168",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100027580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.