Charles David Noll, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS004463L Issued in PA

Practice address

4131 Oregon Pike
Brownstown, PA 17508-0489

Phone

(717) 859-1123

Fax

(717) 859-2898

NPI assigned

Jul 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Lancaster County Medical Group

  dba Wellspan Family Medicine- Crossroads

  • Family Medicine Physician
  • Ephrata, PA
  • NPI 1023048592
  Authorized official Same address or phone
• Northern Lancaster County Medical Group

  • Pulmonary Disease Physician
  • Brownstown, PA
  • NPI 1083665038

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629008198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "address_2": "4131 OREGON PIKE",
            "city": "BROWNSTOWN",
            "state": "PA",
            "postal_code": "175080489",
            "telephone_number": "717-859-1123",
            "fax_number": "717-859-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 OREGON PIKE",
            "city": "BROWNSTOWN",
            "state": "PA",
            "postal_code": "175080489",
            "telephone_number": "717-859-1123",
            "fax_number": "717-859-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004463L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000680630010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "168421",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "52793",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC",
            "identifier": "4663115",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "P002398",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Gracely, LPC
• Donna Kiser, CRNP
• William E Longenecker, D.O.
• Jessica Lauren McGlynn, LPC
• Rose A Medice, CRNP
• Norther Lancaster County Medical Group (Wellspan Family Medicine - Crossroads)
• Northern Lancaster County Medical Group
• Nshape Center (Nsahpe Center)
• James Riley Siegenthaler, D.C.
• Shannon Nicole Strohl

• Family Medicine Physician in Brownstown, PA
• Providers in Brownstown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.