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JERROL NOLLER MD LTD
NPI 1821257593
Clinic/Center - Medical Specialty in Coon Rapids, MN

Active since June 06, 2008
3863 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433(763) 433-8300(763) 433-8308 Get Directions Write a Review

NPPES record last updated: June 6, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerrol Noller Md Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERROL NOLLER MD LTD (NPI 1821257593) is a healthcare organization registered as a medical specialty in Coon Rapids, Minnesota and active in the NPI registry since June 2008. The organization lists Jerrol Jay Noller, President, as its authorized official.

NPPES Registry Identity

NPI1821257593
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameJERROL NOLLER MD LTD
Location Address3863 COON RAPIDS BLVD NWCoon Rapids, MN 55433-2518
Mailing Address1416 Oakwood DrAnoka, MN 55303-2747 · (763) 433-8300 · Fax (763) 433-8308
Phone(763) 433-8300
Fax(763) 433-8308
Organization SubpartNo
Authorized OfficialJerrol Jay NollerPresident · (763) 427-6897
Enumeration DateJune 6, 2008
✔ NPI 1821257593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in MN · 23068
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
3863 COON RAPIDS BLVD NW, Coon Rapids, MN 55433
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Other Identifiers 2

Medicaid774888400MN
Medicare PIN110008247

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JERROL JAY NOLLER M.D.
Internal Medicine
3863 COON RAPIDS BLVD NW
COON RAPIDS, MN 55433
Anoka County (763) 433-8300
BRYANT R. BEEHLER, D.O., LTD.
Clinic/Center (Rehabilitation)
3863 COON RAPIDS BLVD NW
COON RAPIDS, MN 55433
Anoka County (701) 239-3738

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerrol Noller MD Ltd's NPI number?

The NPI number for Jerrol Noller MD Ltd is 1821257593. It was assigned to this organization in the NPPES registry on June 6, 2008.

Where is Jerrol Noller MD Ltd located?

Jerrol Noller MD Ltd is located at 3863 Coon Rapids Blvd NW, Coon Rapids, MN 55433. The listed phone number is (763) 433-8300.

What is Jerrol Noller MD Ltd's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Jerrol Noller MD Ltd was last updated on June 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.