Individual provider Active NPI

Clarke Snodgrass, DO

  • Emergency Medicine Physician
  • Kingman, AZ
National Provider Identifier
1508489451
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A009410 Issued in AZ
Practice address
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone
(928) 263-4466
Fax
(928) 681-8638
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 20A009410 AZ Primary

Addresses

Primary practice location

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221017001298 AZ Practitioner - Emergency Medicine 9739555749 Reassigns benefits to 5 organizations
I20250613001819 TX Practitioner - Emergency Medicine 9739555749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rocky Vista University College of Osteopathic Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 757-2101

Hospital & facility affiliations

  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A009410AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc CurrentSince May 28, 2025 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince May 28, 2025 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Exceptional Physicians Group Yuma Hospital PLLC Emergency Medicine CurrentSince May 14, 2024 Accepting new patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Exceptional Physicians Group Arizona PLLC CurrentSince Jul 1, 2024 Accepting new patients
Exceptional Physicians Group Bullhead City Hospital PLLC CurrentSince Jul 1, 2024 Accepting new patients
Exceptional Health Care Bullhead City LLC PastSince Nov 19, 2023 Accepting new patients

Locations

2365 Highway 95
Bullhead City, AZ 86442
Phone (928) 224-2443

19060 N John Wayne Pkwy
Maricopa, AZ 85139
Phone (480) 631-0675

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

500 Indiana Ave
Winslow, AZ 86047

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

2648 S Araby Rd
Yuma, AZ 85365
Phone 4693417800100

3514 Cedar Springs Rd
Dallas, TX 75219
Phone (281) 415-6687

Organizations & group practices 9

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1508489451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4466",
            "fax_number": "928-681-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "CLARKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "20A009410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.