Individual provider Active NPI

Jared Scott Snyder, PTA

  • Physical Therapy Assistant
  • San Tan Valley, AZ
National Provider Identifier
1285000786
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10177A Issued in AZ
Practice address
1745 E Hunt Hwy
Suite 103
San Tan Valley, AZ 85143
Phone
(480) 568-4580
Fax
(480) 568-4581
NPI assigned
Aug 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10177A AZ Primary

Addresses

Primary practice location

1745 E Hunt Hwy
Suite 103
San Tan Valley, AZ 85143

Mailing address

1745 E Hunt Hwy
Suite 103
San Tan Valley, AZ 85143
Phone (480) 568-4580

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10177AAZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1285000786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 E HUNT HWY",
            "address_2": "SUITE 103",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "85143",
            "telephone_number": "480-568-4580",
            "fax_number": "480-568-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 E HUNT HWY",
            "address_2": "SUITE 103",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "85143",
            "telephone_number": "480-568-4580",
            "fax_number": "480-568-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JARED",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "10177A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.