Individual provider Active NPI

Alexandra Snodgrass, M.D.

  • Dermatology Physician
  • Gainesville, FL
National Provider Identifier
1457732885
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101268348 Issued in VA
Practice address
1600 SW Archer Rd
Shands Hospital, Room 4102
Gainesville, FL 32610-3003
Phone
(352) 265-0239
Fax
(352) 265-1107
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X D0088444 MD
Internal Medicine Physician 207R00000X TRN22091 FL
Dermatology Physician 207N00000X 0101268348 VA Primary

Addresses

Primary practice location

1600 SW Archer Rd
Shands Hospital, Room 4102
Gainesville, FL 32610-3003

Mailing address

1850 Town Center Pwky
Unit 551
Reston, VA 20190
Phone (703) 481-0002

Other names 1

  • Dr. Alexandra Owens Former name

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0088444MDMDDermatology Physician
0101268348VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Naderi Center for Cosmetic Surgery & Skin Care, PLLC Single Specialty CurrentSince May 7, 2024 Accepting new patients

Locations

1850 Town Center Pkwy
Ste 551
Reston, VA 20190
Phone (703) 481-0002

Organizations & group practices 1

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1457732885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PWKY",
            "address_2": "UNIT 551",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-481-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "SHANDS HOSPITAL, ROOM 4102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0239",
            "fax_number": "352-265-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0088444",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN22091",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101268348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "OWENS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.