Taylor Conroy Nottke, DO
NPI 1205458874ActiveIndividual· Pediatrics· Stillwater, MN
Pediatrics (DO) in Stillwater, Minnesota, licensed in MN and WI, with an NPI issued in May 2020. Enrolled in Medicare as practitioner - pediatric medicine and practitioner - pediatric medicine.
Overview
| NPI | 1205458874 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | May 17, 2020 |
| Last updated in NPPES | Aug 3, 2023 |
| Certified by provider | Aug 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | 73652 | MN |
| Pediatrics | 208000000X | 81136-21 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Pediatric Medicine (MN); Practitioner - Pediatric Medicine (WI) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Pediatrics providers in Stillwater
- 1639348477
- 1861477382
- 1063856094
- 1679768048
- 1215253869
- 1780667212
- 1255713632
- 1720234941
- 1518344118
- 1003899089
- 1932184694