Active NPI
Noelle Nielsen
- Obstetrics & Gynecology Physician
- Glens Falls, NY
National Provider Identifier
1790789352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 146970
- Practice address
- 45 Hudson Ave
Glens Falls, NY 12801-4313 - Phone
- (518) 793-4477
- NPI assigned
- Jun 10, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 146970 | NY | Primary |
Addresses
Primary practice location
45 Hudson Ave
Glens Falls, NY 12801-4313
Mailing address
45 Hudson Ave
PO Box 144
Glens Falls, NY 12801-4313
Phone (518) 793-4477
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040426007601 | Other | NY | FIDELIS |
| 78E642 | Other | NY | BLUE CROSS |
| 15124 | Other | NY | MVP |
| 000416199001 | Other | NY | BLUE SHIELD |
| 00912010 | Medicaid | NY | |
| 10001475 | Other | NY | CDPHP |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790789352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 HUDSON AVE",
"address_2": "PO BOX 144",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014313",
"telephone_number": "518-793-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 HUDSON AVE",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014313",
"telephone_number": "518-793-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "NOELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NY",
"license": "146970",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "040426007601",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "78E642",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "15124",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000416199001",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00912010",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10001475",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glens Falls, NY
Sources for this page
- 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.