Individual provider Active NPI

Jonathan Aaron Snow

  • Certified Registered Nurse Anesthetist
  • Wausau, WI
National Provider Identifier
1144573650
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001216831 Issued in VA
Practice address
425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123
Phone
(715) 845-5505
Fax
(715) 848-2884
NPI assigned
Oct 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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 0001216831 VA Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123

Mailing address

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141029001650 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416196175 Reassigns benefits to 1 organization
I20210907000017 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416196175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Shepherd Health Care SystemGroup PAC ID 9133033764, 125 clinicians
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

610 NW 11TH St
Hermiston, OR 97838-6601
Phone (541) 667-3400

939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 417-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
64.68
Promoting interoperability
100
Improvement activities
40
Cost
47.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001216831VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 4, 2025 Accepting new patients
Good Shepherd Health Care System CurrentSince Jul 14, 2021 Accepting new patients
Central Wisconsin Anesthesiology Past Accepting new patients

Locations

600 NW 11th St
Ste E37
Hermiston, OR 97838
Phone (541) 567-5305

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

939 Caroline St
Port Angeles, WA 98362
Phone (360) 417-7315

Organizations & group practices 3

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 2

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": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1144573650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "STE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "STE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "JONATHAN",
        "middle_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001216831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.