Carolyn Allisa Snyder, R.D., L.D.

Individual provider Active NPI Registered Dietitian · Kirksville, MO

NPI 1124355136 · NPPES record last updated Dec 6, 2023

Key facts

NPI
1124355136
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2013014801 (MO)
Practice address
701 S Bradford St
None
Kirksville, MO 63501-5403
Phone
(785) 317-5440
Fax
(660) 730-5042
NPI assigned
Nov 11, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Missouri Health Council Inc (20 clinicians)

Practice addresses (Care Compare)

PO Box
Suite 1027
Kirksville, MO 63501

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160802002495 MO Practitioner - Registered Dietitian Or Nutrition Professional 3577857325 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1376KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Missouri Health Council, Inc Current
since Jun 13, 2016
Accepting new patients
Northeast Missouri Health Council, Inc. Current
since Nov 15, 2023
Accepting new patients
Northeast Missouri Health Council, Inc. Current Accepting new patients
Northeast Missouri Health Council Inc Current
since Nov 15, 2023
Accepting new patients
Northeast Missouri Health Council Inc Current
since Jun 13, 2016
Accepting new patients

Locations

104 E Jackson St
Edina, MO 63537
Phone (660) 397-3517

1416 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

1506 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

402 W Jefferson St
Kirksville, MO 63501
Phone (660) 665-2741

209 N Missouri St
Macon, MO 63552
Phone (660) 385-4999

118 E Grand Ave
Memphis, MO 63555
Phone (660) 465-7522

52334 Business Highway 5
Milan, MO 63556
Phone (660) 265-1042

Interoperability endpoints

  • Direct secure messaging: carolyn.snyder.p1@direct.nmhcinc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1376 KS
Registered Dietitian 133V00000X 2013014801 MO Yes

Addresses

Primary practice location

701 S Bradford St
None
Kirksville, MO 63501-5403

Mailing address

701 S Bradford St
None
Kirksville, MO 63501-5403
Phone (785) 317-5440

Other providers in Kirksville, MO

All providers in Kirksville, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.