Individual provider Active NPI

Kenton W Snyder, CNP

  • Family Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1407388598
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015983 Issued in IL
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-8400
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041393491 IL
Family Nurse Practitioner 363LF0000X 209015983 IL Primary

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170519001306 IL Practitioner - Nurse Practitioner 7810264991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041393491ILMDRegistered Nurse
209015983ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince May 1, 2022 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessing Hospital Current Accepting new patients
Blessing Hospital CurrentSince Apr 19, 2018 Accepting new patients
Blessing Hospital Current Accepting new patients
Blessing Hospital CurrentSince Apr 19, 2018 Accepting new patients
Blessing Hospital Past Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

1005 Broadway St
Quincy, IL 62301

3700 Broadway St
Quincy, IL 62305
Phone (217) 224-7555

1400 Harrison St
Quincy, IL 62301
Phone (217) 214-9696

420 N 34th St
Quincy, IL 62301
Phone (217) 214-9626

3200 Broadway St
Quincy, IL 62301
Phone (217) 224-0776

1805 Elm St
Canton, MO 63435
Phone (573) 288-0355

100 Medical Dr
Hannibal, MO 63401

101 Medical Dr
Hannibal, MO 63401

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 8

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1407388598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "KENTON",
        "middle_name": "W",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041393491",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.