Individual provider Active NPI

Anne Snider, O.D

  • Sports Vision Optometrist
  • Russellville, AR
National Provider Identifier
1073582391
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Vision OptometristTaxonomy code 152WS0006X
License
2484 Issued in AR
Practice address
2409 E Main
Russellville, AR 72802-9619
Phone
(479) 967-0600
Fax
(479) 967-0610
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Vision Optometrist 152WS0006X 2484 AR Primary

Addresses

Primary practice location

2409 E Main
Russellville, AR 72802-9619

Mailing address

2409 E Main
Russellville, AR 72802-9619
Phone (479) 967-0600

Other identifiers 1

IdentifierTypeStateIssuer
135948722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000535 AR Practitioner - Optometry 7113940610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2409 E Main
Russellville, AR 72802-9619
Phone (479) 967-0600

2409 E Main St
Russellville, AR 72802-9619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2484ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Care of Russellville CurrentSince May 1, 2000 Accepting new patients

Locations

2409 E Main St
Russellville, AR 72802
Phone (479) 967-0600

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1073582391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 E MAIN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029619",
            "telephone_number": "479-967-0600",
            "fax_number": "479-967-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 E MAIN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029619",
            "telephone_number": "479-967-0600",
            "fax_number": "479-967-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "ANNE",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "AR",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135948722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.