Individual provider Active NPI

Rickey L Snipes, M.D.

  • Gastroenterology Physician
  • Saint Joseph, MI
National Provider Identifier
1477546869
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301063039 Issued in MI
Practice address
3903 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone
(269) 408-1100
Fax
(269) 408-1329
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301063039 MI Primary

Addresses

Primary practice location

3903 Hollywood Rd
Saint Joseph, MI 49085-9149

Mailing address

3903 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone (269) 408-1100

Other identifiers 2

IdentifierTypeStateIssuer
4301063039OtherMISTATE LICENSE
4214284MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000346 MI Practitioner - Gastroenterology 4183725781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Jul 27, 2023 Accepting new patients
Glec PLLC CurrentSince Jul 10, 2006 Accepting new patients
Lakeland Medical Practices CurrentSince Jul 27, 2023 Accepting new patients

Locations

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

3903 Hollywood Rd
Saint Joseph, MI 49085
Phone (269) 408-1100

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477546869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149",
            "telephone_number": "269-408-1100",
            "fax_number": "269-408-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149",
            "telephone_number": "269-408-1100",
            "fax_number": "269-408-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIPES",
        "first_name": "RICKEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301063039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301063039",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4214284",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.