NPIMap

Individual provider Active NPI

Jeffrey Todd Snyder, MD

  • Emergency Medicine Physician
  • Papillion, NE
National Provider Identifier
1194777623
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22538 Issued in NE
Practice address
11111 S 84TH St
Papillion, NE 68046-4122
Phone
(402) 593-3550
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22538 NE Primary

Addresses

Primary practice location

11111 S 84TH St
Papillion, NE 68046-4122

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164

Other identifiers 8

IdentifierTypeStateIssuer
35465OtherIAWELLMARK BCBS
100251217-00MedicaidNE
100249951-00MedicaidNE
100251147-00MedicaidNE
4298455MedicaidIA
0298455MedicaidIA
5298455MedicaidIA
01267OtherNEBCBS NE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22538NEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health Emergency Medicine Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1194777623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 S 84TH ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464122",
            "telephone_number": "402-593-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JEFFREY",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "22538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "35465",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251217-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100249951-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251147-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4298455",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298455",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5298455",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE",
            "identifier": "01267",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.