Individual provider Active NPI

Katrina Latrice Snider, PMHNP - BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Athens, GA
National Provider Identifier
1366894867
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN255430 Issued in GA
Practice address
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone
(706) 369-6363
Fax
(706) 389-6740
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN255430 GA
Registered Nurse 163W00000X RN9341570 FL
Registered Nurse 163W00000X 258977 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN255430 GA Primary

Addresses

Primary practice location

240 Mitchell Bridge Rd
Athens, GA 30606-2043

Mailing address

240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone (561) 844-2379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20190313000853 GA Practitioner - Nurse Practitioner 1355681214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Behavioral Health SystemsGroup PAC ID 1052200599, 33 clinicians

Practice addresses (Care Compare)

250 Bray St
Athens, GA 30601-2203
Phone 70638967891108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9341570FLMDRegistered Nurse
RN255430GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Mar 6, 2019 Accepting new patients
Thrive Counseling LLC CurrentSince Jan 25, 2019 Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 369-5745

834 Highway 11
Monroe, GA 30655
Phone (706) 542-9700

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1366894867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MITCHELL BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062043",
            "telephone_number": "561-844-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MITCHELL BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062043",
            "telephone_number": "706-369-6363",
            "fax_number": "706-389-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "KATRINA",
        "middle_name": "LATRICE",
        "name_prefix": "Ms.",
        "credential": "PMHNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN255430",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9341570",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "258977",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN255430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.