Active NPI
Pamela R Snider, PHD
- Psychologist
- Montgomery, AL
National Provider Identifier
1063577658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 753
- Practice address
- 4754 Woodmere Blvd
Suite B
Montgomery, AL 36106 - Phone
- (334) 356-8430
- Fax
- (334) 356-8413
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 753 | AL | Primary |
Addresses
Primary practice location
4754 Woodmere Blvd
Suite B
Montgomery, AL 36106
Mailing address
4754 Woodmere Blvd
Suite B
Montgomery, AL 36106
Phone (334) 356-8430
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PLAN #510 | Other | AL | BLUE CROSS BLUE SHIELD |
| PLAN #74611 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063577658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4754 WOODMERE BLVD",
"address_2": "SUITE B",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "36106",
"telephone_number": "334-356-8430",
"fax_number": "334-356-8413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4754 WOODMERE BLVD",
"address_2": "SUITE B",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "36106",
"telephone_number": "334-356-8430",
"fax_number": "334-356-8413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNIDER",
"first_name": "PAMELA",
"middle_name": "R",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AL",
"license": "753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "PLAN #510",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "PLAN #74611",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.