Individual provider Active NPI

Carrie Lynn Snider, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1346467578
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9102393 Issued in FL
Practice address
1707 Riggins Road
Tallahassee, FL 32308-5317
Phone
(850) 877-4134
Fax
(850) 402-9130
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9102393 FL Primary

Addresses

Primary practice location

1707 Riggins Road
Tallahassee, FL 32308-5317

Mailing address

1707 Riggins Road
Tallahassee, FL 32308-5317
Phone (850) 877-4134

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3325GAMDClinical Psychologist
003325GAMDOccupational Therapist
PA 9102393FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Care Physicians of Georgia, P.C. PastSince Dec 1, 1999 Accepting new patients

Organizations & group practices 1

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346467578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS ROAD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS ROAD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9102393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.