Individual provider Active NPI

Kimberly Snyder, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Austin, TX
National Provider Identifier
1003858119
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
J7679 Issued in TX
Practice address
12221 N. Mopac Expressway
Austin, TX 78758
Phone
(512) 901-1000
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X J7679 TX Primary
Emergency Medicine Physician 207P00000X J7679 TX

Addresses

Primary practice location

12221 N. Mopac Expressway
Austin, TX 78758

Mailing address

1906 Holly Hill Dr
Austin, TX 78746-7647
Phone (512) 306-9432

Other identifiers 2

IdentifierTypeStateIssuer
043548901MedicaidTX
043548902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090126000147 TX Practitioner - Emergency Medicine 4587728217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J7679TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Feb 15, 2015 Accepting new patients

Locations

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1003858119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 HOLLY HILL DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467647",
            "telephone_number": "512-306-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N. MOPAC EXPRESSWAY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78758",
            "telephone_number": "512-901-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "J7679",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J7679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043548901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043548902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.