Individual provider Active NPI

Justin Snowden, CRNA

  • Certified Registered Nurse Anesthetist
  • West Monroe, LA
National Provider Identifier
1104841105
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP03916 Issued in LA
Practice address
503 McMillan Rd
West Monroe, LA 71291-5327
Phone
(318) 323-8887
Fax
(847) 615-2858
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP03916 LA Primary

Addresses

Primary practice location

503 McMillan Rd
West Monroe, LA 71291-5327

Mailing address

925 Sherwood Dr
Lake Bluff, IL 60044-2203
Phone (318) 323-8887

Other identifiers 1

IdentifierTypeStateIssuer
1109789MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000090 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224092044 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smso Anesthesia, LLCGroup PAC ID 7012970627, 49 clinicians

Practice addresses (Care Compare)

2408 Broadmoor Blvd
Monroe, LA 71201-2994
Phone (318) 812-1760

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 812-1760

Hospital & facility affiliations

  • Fmol Health St Francis Hospital, Monroe, LA, CCN 190125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP03916LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Smso Anesthesia, LLC CurrentSince May 1, 2024 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients
Iasis Glenwood Regional Medical Center LP CurrentSince Feb 1, 2016 Accepting new patients
Brfhh Monroe LLC CurrentSince Mar 25, 2024 Accepting new patients
Iasis Glenwood Regional Medical Center LP CurrentSince Feb 1, 2016 Accepting new patients
Twin City Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Twin City Anesthesia Past Accepting new patients

Locations

2408 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 410-0002

309 Jackson St
Monroe, LA 71201
Phone (318) 966-4000

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

706 Ross St
Oak Grove, LA 71263
Phone (318) 428-3237

1275 Glenwood Dr
West Monroe, LA 71291
Phone (318) 322-1339

503 McMillan Rd
West Monroe, LA 71291
Phone (318) 329-4200

503 McMillan Rd
#35805
West Monroe, LA 71291

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.

Hospital & facility affiliations 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1104841105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SHERWOOD DR",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442203",
            "telephone_number": "318-323-8887",
            "fax_number": "847-615-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MCMILLAN RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915327",
            "telephone_number": "318-323-8887",
            "fax_number": "847-615-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOWDEN",
        "first_name": "JUSTIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP03916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1109789",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.