Brent Walter Snow, M.D., MBA

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

171674-1205 Issued in UT

Practice address

100 N Mario Capecchi Dr
Ste. 2200
Salt Lake City, UT 84113-1103

Phone

(801) 662-5555

Fax

(801) 662-5547

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1275544454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413035",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413035",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "address_2": "STE. 2200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-5555",
            "fax_number": "801-662-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "BRENT",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "UT",
            "license": "841716741205",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "841716741205",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "UT",
            "license": "171674-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3048900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Henry Snoddy, L.S.A.C.
• Snoqualmie Inc
• Allysha Michelle Snow
• Ariah Marie Snow
• Barbara Ward Snow, DSW/LCSW
• Heidi L. Snow, CSW
• Karleena Snow, DNP, AGACNP
• Kaylee Snow
• Lilly Ann Snow
• Morgan Vern Snow

• Pediatric Urology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatric Urology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.