Active NPI
Laura Snyder, P.A.-C
- Physician Assistant
- Fort Myers, FL
National Provider Identifier
1548287147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9107178
- Practice address
- 4771 S Cleveland Ave
Fort Myers, FL 33907-1317 - Phone
- (239) 343-9800
- Fax
- (239) 343-9848
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2005030570 | MO | |
| Physician Assistant | 363A00000X | 2005030570 | MO | |
| Physician Assistant | 363A00000X | PA9107178 | FL | Primary |
Addresses
Primary practice location
4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010791900 | Medicaid | FL |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005030570 | MO | MD | Emergency Medicine Physician |
| PA9107178 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harre Family Chiropractic | Past | Accepting new patients | |
| St Johns Clinic Inc | Past | Accepting new patients | |
| Laura Bird, MD, LLC | Past | Accepting new patients | |
| Anderson Medical Group, LLC | Past | Accepting new patients | |
| Mercy Clinic Springfield Communities | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- lsnyder85042@direct.leememorial.org
Organizations & group practices 5
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.
-
- General Practice Physician
- Maryville, IL
- NPI 1700807716
-
- Chiropractor
- Florissant, MO
- NPI 1609073410
-
- Family Medicine Physician
- Maryville, IL
- NPI 1083734610
-
- Rural Health Clinic/Center
- Saint James, MO
- NPI 1134251929
Physician Assistant
-
- Durable Medical Equipment & Medical Supplies
- Saint James, MO
- NPI 1548467012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1548287147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9800",
"fax_number": "239-343-9848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4771 S CLEVELAND AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339071317",
"telephone_number": "239-343-9800",
"fax_number": "239-343-9848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "LAURA",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2005030570",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2005030570",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9107178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010791900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.