David Lee Snodgrass, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

881470 Issued in MS

Practice address

1146 Evelyn Gandy Pkwy
Petal, MS 39465-3947

Phone

(601) 584-4309

Fax

(601) 584-4890

NPI assigned

Dec 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: david.snodgrass.2@1930.direct.athenahealth.com

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1396217345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8549",
            "fax_number": "601-261-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 EVELYN GANDY PKWY",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394653947",
            "telephone_number": "601-584-4309",
            "fax_number": "601-584-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-31",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "881470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.snodgrass.2@1930.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1146 Evelyn Gandy Pkwy",
            "city": "Petal",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394653947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Dale Skaggs
• SLM Labs 2
• Jenna Smith
• Lisa Gayle Smith, M.S., CCC-SLP
• Shonesty L. Smith, MSW
• Joy Ann-Marie Sorrells, LMT
• South Mississippi Pharmacists (Park Place Pharmacy)
• Southeast Mississippi Rural Health Initiative, Inc. (Runnelstown School)
• Southeast Mississippi Rural Health Initiative, Inc.
• Southern Grace Services (Southern Grace - Senior Home Care)

• Family Nurse Practitioner in Petal, MS
• Providers in Petal, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.