Elisabeth L Noelke, MD, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J0164 Issued in TX

Practice address

3501 Knickerbocker Rd
San Angelo, TX 76904-7610

Phone

(325) 947-6960

Fax

(800) 809-9641

NPI assigned

Nov 7, 2006

Last updated

Jan 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: enoelke@yourcarecommunity.org

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.

• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149
  Medicare reassignment Care Compare group NPD
• Robert H. Gross PLLC

  • Child & Adolescent Psychiatry Physician
  • San Angelo, TX
  • NPI 1689718785
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1700955390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S ABE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036305",
            "telephone_number": "325-212-9236",
            "fax_number": "800-809-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-947-6960",
            "fax_number": "800-809-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOELKE",
        "first_name": "ELISABETH",
        "middle_name": "L",
        "credential": "MD, PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0164",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN RENDERING NPI",
            "identifier": "8F22613",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111604802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noble Orthodontics
• Noble Psychological Services
• Raymond Reagon Noble Sr., DDS MSD
• Raymond Reagon Noble II, DDS, MS
• Barby Lucinda Nobles, LBSW
• Farida Bhanu Noorbash, DDS
• North Mesa Dental, PC (Allington Dental)
• Northland Hearing Centers, Inc (NewSound Hearing Aid Centers)
• Yvonne Novak, MD
• Danielle Ann Novilla, RPH

• Family Medicine Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.