Amy Gouley Snow, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA179314 Issued in OR

Practice address

360 SW Bond St Ste 310
Bend, OR 97702-3556

Phone

(541) 727-3376

Fax

(800) 514-0191

NPI assigned

Dec 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Amy Gouley Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• A & M Snow, Inc.

  dba Snow Dermatology

  • Dermatology Physician
  • Bend, OR
  • NPI 1902635550
  Medicare reassignment Authorized official
• Peters Dermatology Center

  • Dermatology Physician
  • Bend, OR
  • NPI 1871954214
  NPD (past)
• Beverly Hills Dermatology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
  • NPI 1669886388
  NPD (past)
• Rosario Skin Clinic PC Inc

  dba Rosario Skin Cliniic

  • Medical Specialty Clinic/Center
  • Mount Vernon, WA
  • NPI 1609813385
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1215912712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977090400",
            "telephone_number": "541-727-3376",
            "fax_number": "800-514-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SW BOND ST STE 310",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023556",
            "telephone_number": "541-727-3376",
            "fax_number": "800-514-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "AMY",
        "middle_name": "GOULEY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "17111",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "60240552",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA179314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GOULEY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzanne Jean Smither, LCSW
• Rebecca Ashton Snead
• Bodhi Dawn Snell
• Mathew Snodgrass, MD
• Snow Pine Counseling PLLC
• Jason Kendall Snow, DDS, MS
• Bonnie J. Snyder, LMT
• Danielle Snyder, LCSW
• Lauren Dooley Snyder, MS
• Kimberlee A Soares, PT

• Medical Physician Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.