Individual provider Active NPI

Corinthiann Viola Snodgrass, PA-C

  • Surgical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1538729439
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2019-0028 Issued in NM
Practice address
6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone
(505) 727-6200
Fax
(505) 727-9590
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2019-0028 NM Primary

Addresses

Primary practice location

6701 Jefferson St NE
Albuquerque, NM 87109-4318

Mailing address

6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone (505) 727-6200

Other practice location 1

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

Other identifiers 1

IdentifierTypeStateIssuer
55508251MedicaidNM

Other names 1

  • Corinthiann Viola Hawes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20190716000828 NM Practitioner - Physician Assistant 0648505461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

4701 Montgomery Blvd NE
Albuquerque, NM 87109-1219
Phone (505) 727-7800

6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone (505) 727-6200

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2019-0028NMMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 25, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jun 1, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 25, 2019 Accepting new patients

Locations

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Ste 19400
Rio Rancho, NM 87124
Phone (505) 253-6100

Interoperability endpoints

  • Direct secure messaging: csnodgrass875942@ahs.direct-ci.com

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 3

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1538729439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094318",
            "telephone_number": "505-727-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094318",
            "telephone_number": "505-727-6200",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Central Ave SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871064930",
            "country_code": "US",
            "telephone_number": "505-841-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "CORINTHIANN",
        "middle_name": "VIOLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2019-0028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55508251",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINTHIANN",
            "last_name": "HAWES",
            "middle_name": "VIOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.