Organization Active NPI

Susan T Snider, M.D., P.a.

  • Family Medicine Physician
  • Spruce Pine, NC
National Provider Identifier
1083803142
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23763 Issued in NC
Legal business name
SUSAN T SNIDER, M.D., P.A.
Practice address
36 Hospital Dr
Spruce Pine, NC 28777-8943
Phone
(828) 765-6595
Fax
(828) 765-6599
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Susan T Snider, M.D.
Title
M.D./Owner
Phone
(828) 765-6595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 23763 NC Primary

Addresses

Primary practice location

36 Hospital Dr
Spruce Pine, NC 28777-8943

Mailing address

36 Hospital Dr
Spruce Pine, NC 28777-8943
Phone (828) 765-6595

Other identifiers 3

IdentifierTypeStateIssuer
78352OtherNCBCBSNC PROVIDER NUMBER
5950189MedicaidNC
8978352MedicaidNC

National Provider Directory

National Provider Directory

Locations

36 Hospital Dr
Spruce Pine, NC 28777
Phone (828) 765-1331

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1083803142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HOSPITAL DR",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287778943",
            "telephone_number": "828-765-6595",
            "fax_number": "828-765-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 HOSPITAL DR",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287778943",
            "telephone_number": "828-765-6595",
            "fax_number": "828-765-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN T SNIDER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "828-765-6595",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "23763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER NUMBER",
            "identifier": "78352",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950189",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8978352",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spruce Pine, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.