Individual provider Active NPI

Elizabeth Majorie Snedeker, PA-C

  • Physician Assistant
  • Mt Sterling, KY
National Provider Identifier
1386074052
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2490 Issued in KY
Practice address
401 Commerce Cir
Mt Sterling, KY 40353
Phone
(859) 498-5243
Fax
(859) 498-5396
NPI assigned
Nov 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003945 OH
Physician Assistant 363A00000X PA2490 KY Primary

Addresses

Primary practice location

401 Commerce Cir
Mt Sterling, KY 40353

Mailing address

401 Commerce Cir
Mt Sterling, KY 40353-7815
Phone (859) 498-5243

Other practice location 1

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Other practice location 2

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Other practice location 3

130 Newtowne Sq
Morehead, KY 40351-2406
Phone (606) 740-0986

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
50.003945OHMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1386074052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE CIR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403537815",
            "telephone_number": "859-498-5243",
            "fax_number": "859-498-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 COMMERCE CIR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "40353",
            "telephone_number": "859-498-5243",
            "fax_number": "859-498-5396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Tamarack Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430552303",
            "country_code": "US",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1930 Tamarack Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430552303",
            "country_code": "US",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Newtowne Sq",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403512406",
            "country_code": "US",
            "telephone_number": "606-740-0986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNEDEKER",
        "first_name": "ELIZABETH",
        "middle_name": "MAJORIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003945",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.