Jerrol Noller MD LTD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

23068 Issued in MN

Legal business name

JERROL NOLLER MD LTD

Practice address

3863 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2518

Phone

(763) 433-8300

Fax

(763) 433-8308

NPI assigned

Jun 6, 2008

Last updated

Jun 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerrol Jay Noller, MDNPI 1245343011

Title

President

Phone

(763) 427-6897

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerrol Jay Noller, M.D.

  • Internal Medicine Physician
  • Coon Rapids, MN
  • NPI 1245343011
  Authorized official Same address or phone

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1821257593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 OAKWOOD DR",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032747",
            "telephone_number": "763-433-8300",
            "fax_number": "763-433-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332518",
            "telephone_number": "763-433-8300",
            "fax_number": "763-433-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERROL NOLLER MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "NOLLER",
        "authorized_official_first_name": "JERROL",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-427-6897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "23068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774888400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christen Jensen
• Christine C Jensen, MD
• Eric James Jensen, CRNA
• Janice Lynn Jensen, PHARMD
• Megan Jensen, PT, DPT
• Michael Jewell, PHARMD
• Fathiya Mohamed Jeylani, PA
• Crystal Chun Jiang, DPT
• Ifrah A Jire
• Rebecca Jochum, CMT

• Medical Specialty Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.