Active NPI
Wynelle R Snow, MD
- Psychiatry Physician
- Ketchikan, AK
National Provider Identifier
1427085760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1271
- Practice address
- 21 Jefferson St
Suite 201
Ketchikan, AK 99901-5875 - Phone
- (907) 220-9948
- Fax
- (907) 220-9947
- NPI assigned
- Jun 26, 2006
- Last updated
- Apr 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1271 | AK | Primary |
Addresses
Primary practice location
21 Jefferson St
Suite 201
Ketchikan, AK 99901-5875
Mailing address
PO Box 8202
Ketchikan, AK 99901-3202
Phone (907) 220-9948
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD60041 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060327000846 | AK | Practitioner - Psychiatry | 3274541693 | Practice locations: Ketchikan, AK |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Texas Southwestern Medical School at Dallas, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
21 Jefferson Way
Suite 201
Ketchikan, AK 99901-5951
Phone (907) 220-9948
PO Box
Suite 8202
Ketchikan, AK 99901-3202
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.12 of 100
- Quality
- 81.91
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 40.93
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239840000000",
"number": "1427085760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8202",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999013202",
"telephone_number": "907-220-9948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 JEFFERSON ST",
"address_2": "SUITE 201",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015875",
"telephone_number": "907-220-9948",
"fax_number": "907-220-9947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNOW",
"first_name": "WYNELLE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-26",
"last_updated": "2009-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AK",
"license": "1271",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD60041",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.