Individual provider Active NPI

Tara Beth Snell, PA-C

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1154628709
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1937 Issued in TN
Practice address
760 E Brookhaven Cir
Memphis, TN 38117-4502
Phone
(901) 761-0500
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1937 TN Primary

Addresses

Primary practice location

760 E Brookhaven Cir
Memphis, TN 38117-4502

Mailing address

760 E Brookhaven Cir
Memphis, TN 38117-4502
Phone (901) 761-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110404000521 TN Practitioner - Physician Assistant 3173707957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1937TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tratan LLC Past Accepting new patients
Broken Bow Clinic PC PastSince Oct 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tara.snell.1@3694.direct.athenahealth.com
  • Direct secure messaging: dshepler@directaddress.net
  • FHIR API: https://api.platform.athenahealth.com/3694/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1154628709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 E BROOKHAVEN CIR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174502",
            "telephone_number": "901-761-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 E BROOKHAVEN CIR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174502",
            "telephone_number": "901-761-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELL",
        "first_name": "TARA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.