Michael R Noonan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1786 Issued in AZ

Practice address

106 5TH St S
Walker, MN 56484-1123

Phone

(218) 547-1900

Fax

(218) 547-3913

NPI assigned

Sep 26, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

86.56 of 100Reported as group

Quality

74.25

Promoting interoperability

100

Improvement activities

40

Cost

76.16

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: michael.noonan.p6@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1790886901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 5TH ST S",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "564841123",
            "telephone_number": "218-547-1900",
            "fax_number": "218-547-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-10-05",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "1786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "1786",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn A Mell, MD
• Michael T. Pederson, DDS
• Katherine Marie Miller, FNP-BC
• Vanessa Jane Miller, ARNP
• Mirabilis Health
• James D Olander, R.PH.
• Park Rapids Walker Eye Clinic O.D., P.a.
• Amanda Pederson, NP
• Michael Todd Pederson, DDS
• William M Petersen, MD

• All providers in Walker, MN
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.