NPIMap

Individual provider Active NPI

Stephen Snyder, MD

  • Internal Medicine Physician
  • Little Rock, AR
National Provider Identifier
1053348870
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C-5502 Issued in AR
Practice address
11321 Interstate 30
Suite 101
Little Rock, AR 72209-7059
Phone
(501) 455-1331
Fax
(501) 455-5597
NPI assigned
Jun 27, 2006
Last updated
Jan 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C-5502 AR
Internal Medicine Physician 207R00000X C-5502 AR Primary

Addresses

Primary practice location

11321 Interstate 30
Suite 101
Little Rock, AR 72209-7059

Mailing address

11321 Interstate 30
Suite 101
Little Rock, AR 72209-7059
Phone (501) 455-1331

Other identifiers 1

IdentifierTypeStateIssuer
110127001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100623000801 AR Practitioner - Internal Medicine 6103957964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

11321 Interstate 30
Suite 101
Little Rock, AR 72209-7064
Phone (501) 455-1331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-5502ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Current Accepting new patients
Arkansas Health Group Family Medicine CurrentSince Mar 4, 2013 Accepting new patients
Arkansas Health Group CurrentSince Mar 4, 2013 Accepting new patients
Otter Creek Family Clinic PLLC Internal Medicine PastSince Apr 20, 2010 Accepting new patients
Arkansas Health Group Family Medicine Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

11321 Interstate 30
Ste 101
Little Rock, AR 72209
Phone (501) 455-1331

500 S University Ave
Ste 321
Little Rock, AR 72205
Phone (501) 664-1272

Interoperability endpoints

  • Direct secure messaging: ssnyder1972@direct.baptist-healthar.org

Organizations & group practices 5

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1053348870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 INTERSTATE 30",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097059",
            "telephone_number": "501-455-1331",
            "fax_number": "501-455-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11321 INTERSTATE 30",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097059",
            "telephone_number": "501-455-1331",
            "fax_number": "501-455-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-5502",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C-5502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110127001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.