Individual provider Active NPI

Kevin K. Snyder, MD

  • Psychiatry Physician
  • Colorado Springs, CO
National Provider Identifier
1013946706
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41126 Issued in CO
Practice address
1115 Elkton Dr Ste 300
Colorado Springs, CO 80907-3597
Phone
(719) 373-9703
Fax
(719) 631-7017
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 41126 CO
Psychiatry Physician 2084P0800X 41126 CO Primary

Addresses

Primary practice location

1115 Elkton Dr Ste 300
Colorado Springs, CO 80907-3597

Mailing address

1115 Elkton Dr Ste 300
Colorado Springs, CO 80907-3597
Phone (719) 373-9703

Other identifiers 1

IdentifierTypeStateIssuer
01887017MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110609000418 CO Practitioner - Psychiatry 4688568678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Achieve Whole Recovery, PCGroup PAC ID 8123388527, 23 clinicians

Practice addresses (Care Compare)

1115 Elkton Dr
Suite 300
Colorado Springs, CO 80907-3597
Phone (719) 373-9703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41126COMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Whole Recovery PC CurrentSince Nov 19, 2017 Accepting new patients
Achieve Whole Recovery, PC CurrentSince Nov 19, 2017 Accepting new patients
Achieve Whole Recovery PC Past Accepting new patients
Achieve Whole Recovery PC Past Accepting new patients
The B&B Group LLC Past Accepting new patients
Achieve Whole Recovery, PC Past Accepting new patients

Locations

1115 Elkton Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 357-6471

8380 Zuni St
Ste 305
Westminster, CO 80221
Phone (719) 357-6471

Organizations & group practices 7

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1013946706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-373-9703",
            "fax_number": "719-631-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-373-9703",
            "fax_number": "719-631-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "KEVIN",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CO",
            "license": "41126",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "41126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01887017",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.