Active NPI
Susanne Mills Snider, CRNP
- Family Nurse Practitioner
- Northport, AL
National Provider Identifier
1124113394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-068376
- Practice address
- 2810 Lurleen Wallace Blvd
Northport, AL 35476-3249 - Phone
- (205) 373-6323
- Fax
- (205) 373-2544
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-068376 | AL | Primary |
Addresses
Primary practice location
2810 Lurleen Wallace Blvd
Northport, AL 35476-3249
Mailing address
12792 Shelly Hughes Rd
Buhl, AL 35446-9164
Phone (205) 339-7165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104831 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
302 Merchants Walk
Suite 100
Tuscaloosa, AL 35406-2291
Phone (205) 523-9300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama Ear, Nose & Throat Specialists, LLC | Current | Accepting new patients |
Locations
302 Merchants Walk
Ste 100
Tuscaloosa, AL 35406
Phone (205) 523-9300
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHCHCA
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.
-
- Otolaryngology Physician
- Tuscaloosa, AL
- NPI 1023421468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345420800000",
"number": "1124113394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12792 SHELLY HUGHES RD",
"city": "BUHL",
"state": "AL",
"postal_code": "354469164",
"telephone_number": "205-339-7165",
"fax_number": "205-373-2544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 LURLEEN WALLACE BLVD",
"city": "NORTHPORT",
"state": "AL",
"postal_code": "354763249",
"telephone_number": "205-373-6323",
"fax_number": "205-373-2544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNIDER",
"first_name": "SUSANNE",
"middle_name": "MILLS",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2012-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-068376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104831",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northport, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.
- 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.