Individual provider Active NPI

Mary Dodich Snelgrove, FNP-C, MSN

  • Nurse Practitioner
  • Oroville, CA
National Provider Identifier
1194744748
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11984NP Issued in CA
Practice address
2767 Olive Hwy
Oroville, CA 95966-6118
Phone
(530) 532-8584
Fax
(530) 532-8272
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11984NP CA Primary

Addresses

Primary practice location

2767 Olive Hwy
Oroville, CA 95966-6118

Mailing address

2767 Olive Hwy
Oroville, CA 95966-6118
Phone (530) 532-8584

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ15808ZMedicaidCA

Other names 1

  • Mary M Dodich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050609000801 CA Practitioner - Nurse Practitioner 9133162159 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11984NPCAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System CurrentSince Jul 30, 2011 Accepting new patients
Enloe Medical Center CurrentSince Jun 19, 2013 Accepting new patients
Chico Emergency Physicians Medical Group, Inc CurrentSince Nov 1, 2014 Accepting new patients
Enloe Medical Center CurrentSince Jun 19, 2013 Accepting new patients
Enloe Medical Center CurrentSince Jan 4, 2015 Accepting new patients

Locations

888 Lakeside Vlg Cmns
Chico, CA 95928
Phone (530) 332-6800

560 Cohasset Rd
Chico, CA 95926
Phone (530) 332-4470

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

Organizations & group practices 5

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1194744748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-532-8584",
            "fax_number": "530-532-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-532-8584",
            "fax_number": "530-532-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELGROVE",
        "first_name": "MARY",
        "middle_name": "DODICH",
        "credential": "FNP-C, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11984NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ15808Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DODICH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.